Individual
MRS. CRYSTAL MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
354 S DECATUR BLVD, LAS VEGAS, NV 89107-2804
(702) 822-1177
Mailing address
354 S DECATUR BLVD, LAS VEGAS, NV 89107-2804
(702) 822-1177
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
02/25/2019
Last updated
02/25/2019
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