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1164562120
IRENE MARY BOURGAULT
LAS VEGAS, NV
NPI
1164562120
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: NV 350)
Enumeration Date
2007-02-07
Last Update Date
2012-11-14
Business Address
Dr. IRENE MARY BOURGAULT D.O.
3150 N TENAYA WAY 660
LAS VEGAS, NV 89128-0443
Phone number: 702-648-6228
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Mailing Address
Dr. IRENE MARY BOURGAULT D.O.
3150 N TENAYA WAY 660
LAS VEGAS, NV 89128-0443
Phone number: 702-648-6228
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