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1720398159
ANTHONY JACOB BACA
LAS VEGAS, NV
NPI
1720398159
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225400000X Rehabilitation Practitioner
Enumeration Date
2010-10-19
Last Update Date
2010-10-19
Business Address
-- ANTHONY JACOB BACA
5105 SMOKE RANCH RD
LAS VEGAS, NV 89108-3536
Phone number: 702-638-0395
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Mailing Address
-- ANTHONY JACOB BACA
5105 SMOKE RANCH RD
LAS VEGAS, NV 89108-3536
Phone number: 702-638-0395
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