Individual
TAMMY MICHELE JETTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
202 FULLERTON AVE, HENDERSON, NV 89015-5223
(702) 349-4194
Mailing address
202 FULLERTON AVE, HENDERSON, NV 89015-5223
(702) 349-4194
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/03/2017
Last updated
11/03/2017
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