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1487043139
DE'JUAN LAMAR WALLACE
LAS VEGAS, NV
NPI
1487043139
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225400000X Rehabilitation Practitioner
Enumeration Date
2015-01-20
Last Update Date
2015-01-20
Business Address
Mr. DE'JUAN LAMAR WALLACE
6889 S EASTERN AVE
LAS VEGAS, NV 89119-4687
Phone number: 702-802-4900
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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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