Individual
MRS. CAROL ANNETTE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
725 PRINCESS AVE, N LAS VEGAS, NV 89030-3822
(702) 443-4763
Mailing address
725 PRINCESS AVE, N LAS VEGAS, NV 89030-3822
(702) 443-4763
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
07/07/2011
Last updated
07/07/2011
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