Individual
WILLIE MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5258 S EASTERN AVE, 105, LAS VEGAS, NV 89119-2326
(702) 464-5080
Mailing address
10245 S MARYLAND PKWY UNIT 1195, LAS VEGAS, NV 89183-4058
(810) 447-1977
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
10/29/2015
Last updated
10/29/2015
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