Individual
MR. IVAN REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4760 S PECOS RD, LAS VEGAS, NV 89121-5828
(702) 966-6570
(702) 838-4967
Mailing address
4760 S PECOS RD, LAS VEGAS, NV 89121-5828
(702) 966-6570
(702) 838-4967
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013239573
—
NV
Enumeration date
09/13/2010
Last updated
09/13/2010
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