Individual
MALINIE NITIVONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2820 W CHARLESTON BLVD # C23, LAS VEGAS, NV 89102-1942
(702) 437-4673
Mailing address
2607 RED ROCK ST, 2-101, LAS VEGAS, NV 89146-5399
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
05/26/2011
Last updated
05/26/2011
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