Individual
JORDAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2075 E FLAMINGO RD -SOUTHMAGNA, ROOM242, LAS VEGAS, NV 89119-5188
(702) 592-0069
Mailing address
6070 BURLESON RANCH RD, LAS VEGAS, NV 89131-3142
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
39201-DI-0
NV
Other
Enumeration date
10/25/2017
Last updated
10/25/2017
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