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1376366617
BLAKE BACON
LAS VEGAS, NV
NPI
1376366617
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2024-11-05
Last Update Date
2024-11-05
Business Address
BLAKE BACON
4245 S GRAND CANYON DR
LAS VEGAS, NV 89147-7161
Phone number: 725-745-3741
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Mailing Address
BLAKE BACON
4245 S GRAND CANYON DR
LAS VEGAS, NV 89147-7161
Phone number: 725-745-3741
Copy
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