Individual
CASEY MATTHEW TIEFENTHALER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
6900 N PECOS RD, NORTH LAS VEGAS, NV 89086-4400
(702) 372-1608
Mailing address
6900 N PECOS RD, NORTH LAS VEGAS, NV 89086-4400
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
84180
CA
183500000X
Pharmacist
P9028
ID
Other
Enumeration date
09/01/2020
Last updated
03/24/2021
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