JACK LAVIVONG

LAS VEGAS, NV
NPI1669080693
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy3747P1801X Technician, Personal Care Attendant
Enumeration Date2020-07-15
Last Update Date2020-07-15
Business Address
JACK LAVIVONG
5858 S PECOS RD # I-100
LAS VEGAS, NV 89120-5401
Phone number: 702-855-3382
Mailing Address
JACK LAVIVONG
5858 S PECOS RD # I-100
LAS VEGAS, NV 89120-5401
Phone number: