Individual
MR. JIMMY GLEN COLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.O
Contact information
Practice address
500 S RANCHO DR, #8B, LAS VEGAS, NV 89106-4844
(702) 293-5502
(702) 242-5572
Mailing address
500 S RANCHO DR, #8B, LAS VEGAS, NV 89106-4844
(702) 293-5502
(702) 242-5572
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
H13-00347-2-143805
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100509314
—
NV
Enumeration date
03/31/2009
Last updated
03/31/2009
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