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Individual

FREDERICK DUBOIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
630 S RANCHO DR STE D, LAS VEGAS, NV 89106-4849
(702) 878-2244
Mailing address
1845 WALKER LN, HENDERSON, NV 89014-4015
(702) 217-2346

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1631
LICENSE #
NV
Enumeration date
08/23/2006
Last updated
06/07/2011
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