Most Relevant Information
Provider Data
NPI Number: | 1003576612 |
Provider Name: | JUANITA SCOTT-RAINES |
Entity Type: | Individual |
Taxonomy Code: | 3747P1801X |
Specialty: | Technician |
License Number: |
Most Important Dates
Enumeration Date: | 12/22/2021 |
Last Updated: | 12/22/2021 |
Provider Practice Location
2909 MILO WAY
LAS VEGAS
NV
891020132
Practice Location Phone/Fax
Phone: | 7029869146 |
Fax: |
Provider Mailing Location
410 S RAMPART BLVD STE 390
LAS VEGAS
NV
891455749
Provider Mailing Phone/Fax
Phone: | |
Fax: |