Individual
TENNILLE RENAE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3925 N MARTIN L KING BLVD STE 202, NORTH LAS VEGAS, NV 89032-7675
(702) 909-9333
(702) 909-9262
Mailing address
5244 TAMARUS ST APT D, LAS VEGAS, NV 89119-5045
(312) 852-9265
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
02/21/2018
Last updated
03/17/2018
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