Most Relevant Information
Provider Data
| NPI Number: | 1003467457 |
| Provider Name: | SHUNTAIL THOMPSON |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/26/2019 |
| Last Updated: | 09/26/2019 |
Provider Practice Location
1100 DUMONT BLVD # 2020C
LAS VEGAS
NV
891694265
Practice Location Phone/Fax
| Phone: | 8705498865 |
| Fax: |
Provider Mailing Location
1100 DUMONT BLVD # 2020C
LAS VEGAS
NV
891694265
Provider Mailing Phone/Fax
| Phone: | 8705498865 |
| Fax: |