Individual
GREGORY JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
314 FOREMASTER LN, LAS VEGAS, NV 89101-1008
(702) 857-8800
Mailing address
3035 S MARYLAND PKWY, LAS VEGAS, NV 89109-2200
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
12/06/2023
Last updated
12/06/2023
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