Individual
ENRIQUE PEON-DE LA FUENTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5038 MORRIS ST, LAS VEGAS, NV 89122-7030
(786) 262-1162
Mailing address
5038 MORRIS ST, LAS VEGAS, NV 89122-7030
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/27/2015
Last updated
10/27/2015
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