Individual
MR. MARVIN CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1248 LAWRY AVE, LAS VEGAS, NV 89106-2357
(702) 517-3068
Mailing address
1248 LAWRY AVE, LAS VEGAS, NV 89106-2357
(702) 517-3068
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
225400000X
—
NV
Enumeration date
08/15/2011
Last updated
08/15/2011
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