DE'JUAN LAMAR WALLACE

LAS VEGAS, NV
NPI1487043139
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225400000X Rehabilitation Practitioner
Enumeration Date2015-01-20
Last Update Date2015-01-20
Business Address
Mr. DE'JUAN LAMAR WALLACE
6889 S EASTERN AVE
LAS VEGAS, NV 89119-4687
Phone number: 702-802-4900
Mailing Address
Mr. DE'JUAN LAMAR WALLACE
4130 N MLK BLVD
NORTH LAS VEGAS, NV 89032-0299
Phone number: 702-802-5757
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