Jerrell De'andre Roberts

NPI 1003195488 - Rehabilitation Practitioner - 225400000X

NPI Details
NPI 1003195488
Gender Male
Enumeration Date 08/16/2011
Last Updated 09/16/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
2704 PROSPECTOR MINE AVE
NORTH LAS VEGAS NV, 89031-1188, US
Phone (702) 647-5300
Fax
Business Location
2704 PROSPECTOR MINE AVE
NORTH LAS VEGAS NV, 89031-1188, US
Phone (702) 647-5300
Fax
Toxanomy
Taxonomy Code 225400000X
License State
License Number
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According to our database, Mr. Jerrell De'andre Roberts NPI is 1003195488, taxonomy code is 225400000X Jerrell De'andre Roberts physically located at 2704 Prospector Mine Ave, North Las Vegas NV, 89031-1188. NPI Number Jerrell De'andre Roberts has the Individual type.

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1003195488 NPI number is provided on an as is basis without warranty of any kind. 1003195488 is maintained by the National Plan & Provider Enumeration System. The contents of Jerrell De'andre Roberts are for informational purposes only.