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Individual

MR. JAY JEFFERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5366 SANTA LUPE AVE, SPARKS, NV 89436-3646
(775) 626-5755
(775) 626-5755
Mailing address
5366 SANTA LUPE AVE, SPARKS, NV 89436-3646
(775) 626-5755
(775) 626-5755

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9005041726
NV
Enumeration date
12/30/2015
Last updated
12/30/2015
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