Individual
JESSE JAMES GODDARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2320 E VIKING RD, LAS VEGAS, NV 89169-3356
(720) 404-0394
Mailing address
2320 E VIKING RD, LAS VEGAS, NV 89169-3356
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
12/17/2025
Last updated
12/17/2025
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