Individual
TERESA BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2715 E RUSSELL RD, LAS VEGAS, NV 89120-2426
(702) 483-5919
Mailing address
1109 FERGUSON AVE, NORTH LAS VEGAS, NV 89030-1611
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
07/09/2015
Last updated
07/09/2015
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