Individual
TAVON FULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
955 W CRAIG RD STE 114, NORTH LAS VEGAS, NV 89032-0284
(702) 874-4484
Mailing address
955 W CRAIG RD STE 114, NORTH LAS VEGAS, NV 89032-0284
(702) 874-4484
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
10/26/2022
Last updated
10/26/2022
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