Most Relevant Information
Provider Data
| NPI Number: | 1003584079 |
| Provider Name: | ANTHONY CANCELLARO |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/02/2021 |
| Last Updated: | 09/02/2021 |
Provider Practice Location
4785 S PEARL ST
LAS VEGAS
NV
891216047
Practice Location Phone/Fax
| Phone: | 7029295174 |
| Fax: |
Provider Mailing Location
410 S RAMPART BLVD STE 390
LAS VEGAS
NV
891455749
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |