Individual
ALEX RADDAVONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3355 SPG MNT RD STE 67, LAS VEGAS, NV 89102-8633
(702) 909-6391
Mailing address
3355 SPG MNT RD STE 67, LAS VEGAS, NV 89102-8633
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
04/26/2023
Last updated
04/26/2023
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