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Organization

MACY VEZINA RD LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MACY VEZINA (OWNER)
(310) 922-0270
Entity
Organization

Contact information

Practice address
3365 E FLAMINGO RD STE 9, LAS VEGAS, NV 89121-7440
(310) 922-0270
Mailing address
5405 RUSTY ANCHOR CT, LAS VEGAS, NV 89130-1547
(310) 922-0270

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary

Other

Enumeration date
11/08/2021
Last updated
11/08/2021
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