Individual
MICHELLE SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
4505 S MARYLAND PKWY, LAS VEGAS, NV 89154-9900
(702) 895-1015
Mailing address
4505 S MARYLAND PKWY, LAS VEGAS, NV 89154-9900
(702) 895-1015
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0506131
NV
Other
Enumeration date
01/22/2017
Last updated
01/22/2017
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