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Individual

MELODIE G MANTOOTH NULL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
250 PILOT RD STE 250, LAS VEGAS, NV 89119-3514
(702) 982-3292
(702) 982-5286
Mailing address
3251 CASEY DR APT 104, LAS VEGAS, NV 89120-1104
(702) 833-0445

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
17934
NV

Other

Enumeration date
05/14/2024
Last updated
05/14/2024
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