Individual
JUSTIN ROLAND BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2770 S MARYLAND PKWY, SUITE 211, LAS VEGAS, NV 89109-1554
(702) 675-3400
Mailing address
2770 S MARYLAND PKWY, SUITE 211, LAS VEGAS, NV 89109-1554
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
04/22/2014
Last updated
04/22/2014
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