Individual
TY'VON JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1771 E FLAMINGO RD STE 220A, LAS VEGAS, NV 89119-0850
(702) 560-2192
Mailing address
8920 ATTIC GRACE AVE, LAS VEGAS, NV 89149-3002
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
NV
Other
Enumeration date
09/22/2022
Last updated
09/22/2022
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