Individual
JOSE DIAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
421 S DECATUR BLVD, LAS VEGAS, NV 89107-2812
(702) 462-2325
(702) 462-5938
Mailing address
6385 BLACK SWAN LN, LAS VEGAS, NV 89118-1998
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
08/28/2021
Last updated
06/20/2024
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