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Individual

MR. VIRGIL EARL BRECKENRIDGE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4700 LAS VEGAS BLVD NORTH, NELLIS AFB, NV 89191-6601
(702) 653-3512
Mailing address
2605 TORCH AVE, NORTH LAS VEGAS, NV 89081-6557

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
709223
TX

Other

Enumeration date
06/16/2009
Last updated
06/16/2009
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