Individual
CHANEL WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
224 S. JONES LV NV, NV, NV 89107
(702) 822-1206
(702) 822-1124
Mailing address
224 S. JONES LV NV, NV, NV 89107
(702) 822-1206
(702) 822-1124
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
01/02/2013
Last updated
01/02/2013
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