Most Relevant Information
Provider Data
| NPI Number: | 1003591728 |
| Provider Name: | JOHNATHAN PERALES |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/20/2023 |
| Last Updated: | 06/20/2023 |
Provider Practice Location
1708 E MCWILLIAMS AVE
LAS VEGAS
NV
891012755
Practice Location Phone/Fax
| Phone: | 7028127970 |
| Fax: | 7023578317 |
Provider Mailing Location
1708 E MCWILLIAMS AVE
LAS VEGAS
NV
891012755
Provider Mailing Phone/Fax
| Phone: | 7028127970 |
| Fax: | 7023578317 |