Individual
JERRY GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3965 W CHEYENNE AVE STE 101, NORTH LAS VEGAS, NV 89032-8905
(702) 515-4009
Mailing address
6174 MEADOWGRASS LN, LAS VEGAS, NV 89103-1118
(435) 212-1335
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3319
NV
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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