KENNETH DAWYANE MACK

LAS VEGAS, NV
NPI1891054763
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy172V00000X Community Health Worker
Enumeration Date2012-05-11
Last Update Date2012-05-11
Business Address
KENNETH DAWYANE MACK
1050 E FLAMINGO RD STE. E-120
LAS VEGAS, NV 89119-7427
Phone number: 702-733-8098
Mailing Address
KENNETH DAWYANE MACK
1050 E. FLAMINGO RD STE. E-120
LAS VEGAS, NV 89119-9146
Phone number: 702-733-8098