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1063055150
STACY PETERSEN
LAS VEGAS, NV
NPI
1063055150
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic
Enumeration Date
2019-10-22
Last Update Date
2019-10-22
Business Address
STACY PETERSEN
9811 W CHARLESTON BLVD # 2-641
LAS VEGAS, NV 89117-7528
Phone number: 855-864-4322
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Mailing Address
STACY PETERSEN
1571 PLAZA CENTRE DR
LAS VEGAS, NV 89135-3408
Phone number: 225-571-6079
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