Individual
GRENDALE VELASCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3835 S JONES BLVD, SUITE 104, LAS VEGAS, NV 89103-7125
(702) 880-4193
(702) 880-4197
Mailing address
4616 W SAHARA AVE, #337, LAS VEGAS, NV 89102-3654
(702) 880-4193
(702) 880-4197
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2059
NV
Other
Enumeration date
12/18/2013
Last updated
12/18/2013
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