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1851065015
JOSE LUIS LEON BALLASTER
LAS VEGAS, NV
NPI
1851065015
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2021-08-02
Last Update Date
2021-08-02
Business Address
JOSE LUIS LEON BALLASTER
2770 S MARYLAND PKWY
LAS VEGAS, NV 89109-1554
Phone number: 702-463-7779
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Mailing Address
JOSE LUIS LEON BALLASTER
2770 S MARYLAND PKWY
LAS VEGAS, NV 89109-1554
Phone number: 702-463-7779
Copy
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