Individual
JAN RENE QUATTRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
224 MAZATLAN ST, HENDERSON, NV 89074-5262
(702) 302-1569
Mailing address
224 MAZATLAN ST, HENDERSON, NV 89074-5262
(702) 302-1569
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
05/09/2014
Last updated
05/09/2014
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