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Individual

MS. PHUNG HORTON JEFFERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1448 E CHARLESTON BLVD, LAS VEGAS, NV 89104-1705
(702) 401-3632
(702) 382-4071
Mailing address
1448 E CHARLESTON BLVD, LAS VEGAS, NV 89104-1705
(702) 401-3632
(702) 382-4071

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary

Other

Enumeration date
07/19/2013
Last updated
07/19/2013
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