Individual
CARRIE WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9823 HAVASUPAI AVE, LAS VEGAS, NV 89148-1740
(702) 834-3212
Mailing address
9823 HAVASUPAI AVE, LAS VEGAS, NV 89148-1740
(702) 834-3212
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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