Individual
NICHOLAS EDWARD DOUROUX SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1295 GRAND SUMMIT DR, 244, RENO, NV 89523-2622
(310) 962-4036
Mailing address
1295 GRAND SUMMIT DR, 244, RENO, NV 89523-2622
(310) 962-4036
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00001283458
—
NV
Enumeration date
04/02/2012
Last updated
04/02/2012
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