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1891054763
KENNETH DAWYANE MACK
LAS VEGAS, NV
NPI
1891054763
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2012-05-11
Last Update Date
2012-05-11
Business Address
KENNETH DAWYANE MACK
1050 E FLAMINGO RD STE. E-120
LAS VEGAS, NV 89119-7427
Phone number: 702-733-8098
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Mailing Address
KENNETH DAWYANE MACK
1050 E. FLAMINGO RD STE. E-120
LAS VEGAS, NV 89119-9146
Phone number: 702-733-8098
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