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Individual

MR. JOHNATHAN IRVIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2950 E FLAMINGO RD STE B, LAS VEGAS, NV 89121-5208
(702) 586-9674
Mailing address
2451 N RAINBOW BLVD UNIT 2118, LAS VEGAS, NV 89108-4513
(702) 752-7606

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary

Other

Enumeration date
07/13/2018
Last updated
03/06/2019
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