Individual
JONATHAN JACOB MIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2298 W HORIZON RIDGE PKWY, SUITE 201, HENDERSON, NV 89052-2696
(702) 363-7284
Mailing address
2298 W HORIZON RIDGE PKWY, SUITE 201, HENDERSON, NV 89052-2696
(702) 363-7284
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
02/06/2013
Last updated
02/06/2013
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