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