Individual
ANTHONY BASULTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5099 NATIONAL AVE, LAS VEGAS, NV 89146-7076
(702) 272-3584
Mailing address
5099 NATIONAL AVE, LAS VEGAS, NV 89146-7076
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
08/01/2019
Last updated
08/01/2019
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