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1043988025
ANFERNEE MANIVONG
LAS VEGAS, NV
NPI
1043988025
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician Personal Care Attendant
Enumeration Date
2021-09-02
Last Update Date
2021-09-02
Business Address
ANFERNEE MANIVONG
1951 STELLA LAKE ST STE 36
LAS VEGAS, NV 89106-2144
Phone number: 702-498-1223
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Mailing Address
ANFERNEE MANIVONG
1951 STELLA LAKE ST STE 36
LAS VEGAS, NV 89106-2144
Phone number: 702-498-1223
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