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1972844553
BRODERIC D IVERY
NORTH LAS VEGAS, NV
NPI
1972844553
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225400000X Rehabilitation Practitioner
Enumeration Date
2013-03-07
Last Update Date
2013-03-07
Business Address
Mr. BRODERIC D IVERY
1915 ONA MARIE AVE
NORTH LAS VEGAS, NV 89032-4866
Phone number: 702-812-4973
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Mailing Address
Mr. BRODERIC D IVERY
1915 ONA MARIE AVE
NORTH LAS VEGAS, NV 89032-4866
Phone number: 702-812-4973
Copy
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