Most Relevant Information
Provider Data
| NPI Number: | 1003194663 |
| Provider Name: | JACOB TRICE |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/01/2011 |
| Last Updated: | 08/01/2011 |
Provider Practice Location
1050 E FLAMINGO RD
STE E-120
LAS VEGAS
NV
891197427
Practice Location Phone/Fax
| Phone: | 7027338098 |
| Fax: |
Provider Mailing Location
1050 E FLAMINGO RD
STE E-120
LAS VEGAS
NV
891197427
Provider Mailing Phone/Fax
| Phone: | 7027338098 |
| Fax: |