Individual
ANTOINETA DE GRACIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1750 KAREN AVE APT 28, LAS VEGAS, NV 89169-8719
(702) 333-4674
Mailing address
1816 N DECATUR BLVD UNIT 103, LAS VEGAS, NV 89108-2297
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
08/22/2019
Last updated
08/22/2019
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