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Individual

MS. REGINA JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5254 PARADISE SKIES AVENUE, LAS VEGAS, NV 89156
(702) 445-5858
Mailing address
5254 PARADISE SKIES AVE, LAS VEGAS, NV 89156-5654
(702) 445-5858

Taxonomy

Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary

Other

Enumeration date
10/25/2010
Last updated
01/06/2014
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