Individual
GEORGETTE DOMENECH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4040 S EASTERN AVE STE 300, LAS VEGAS, NV 89119-0854
(702) 463-0300
Mailing address
3896 UNIVERSITY CENTER DR UNIT 2212, LAS VEGAS, NV 89119-7508
(262) 902-0541
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
840115
NV
Other
Enumeration date
12/29/2023
Last updated
12/29/2023
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