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Individual

ANTONIO BASILIO MALIGAYA BANDALES II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5515 S. DURANGO DR. STE 120, LAS VEGAS, NV 89113
(702) 869-4401
Mailing address
6535 AUSTIN HOPE AVE, LAS VEGAS, NV 89118-6096
(702) 881-8061

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4830
NV

Other

Enumeration date
07/05/2022
Last updated
07/08/2022
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