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Individual

IVIE LEE SAMUEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1881 W ALEXANDER RD UNIT 2061, N LAS VEGAS, NV 89032-9044
(702) 326-5505
Mailing address
1881 W. ALEXANDER RD. UNIT 2061, N. LAS VEGAS, NV 89032
(702) 326-5505

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary

Other

Enumeration date
10/16/2012
Last updated
10/16/2012
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