Individual
DR. JED LESTER BARTOLOME ANISCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
5801 W CRAIG RD STE 110, LAS VEGAS, NV 89130-2504
(725) 251-2253
(725) 251-2646
Mailing address
7960 RAFAEL RIVERA WAY UNIT 1292, LAS VEGAS, NV 89113-5355
(702) 330-7168
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19983
NV
Other
Enumeration date
02/23/2021
Last updated
05/06/2022
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