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Organization

EVOLUTION OF LIFE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOSEPH ASHLEY WATKINS (OWNER/CFO)
(702) 528-8968
Entity
Organization

Contact information

Practice address
6074 SECRET ISLAND DR, LAS VEGAS, NV 89139-6250
(702) 528-8968
Mailing address
2355 N HWY 360 APT 521, GRAND PRAIRIE, TX 75050-8715
(702) 528-8968

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary

Other

Enumeration date
05/17/2014
Last updated
05/17/2014
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