Individual
AHTICHA C JIMMERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 W CHEYENNE AVE APT 2138, NORTH LAS VEGAS, NV 89030-7825
(702) 349-8616
Mailing address
1200 W CHEYENNE AVE APT 2138, NORTH LAS VEGAS, NV 89030-7825
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
02/16/2012
Last updated
02/16/2012
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