Individual
DOMINIQUE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1180 N TOWN CENTER DR, LAS VEGAS, NV 89144-6363
(702) 374-8500
Mailing address
1180 N TOWN CENTER DR, LAS VEGAS, NV 89144-6363
(702) 374-8500
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
09/15/2016
Last updated
09/15/2016
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