Individual
MADELAINE LAZO-CHINEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4550 W OAKEY BLVD STE 111-O, LAS VEGAS, NV 89102-1581
(702) 861-0238
Mailing address
7300 LA MONA CT, LAS VEGAS, NV 89128-0541
(702) 802-9058
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
20161065817
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821520016
—
NV
Enumeration date
07/23/2018
Last updated
07/23/2018
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