Individual
LOUISE GORMLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1324 BRACKEN AVE, LAS VEGAS, NV 89104
(702) 771-6882
Mailing address
1324 BRACKEN AVE, LAS VEGAS, NV 89104
(702) 771-6882
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/05/2012
Last updated
09/05/2012
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