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1073264305
RUSSELL IDEISHI
NORTH LAS VEGAS, NV
NPI
1073264305
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2022-01-18
Last Update Date
2022-01-18
Business Address
RUSSELL IDEISHI
517 COUNT AVE
NORTH LAS VEGAS, NV 89030-8630
Phone number: 702-778-7440
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Mailing Address
RUSSELL IDEISHI
517 COUNT AVE
NORTH LAS VEGAS, NV 89030-8630
Phone number: 702-778-7440
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