Most Relevant Information
Provider Data
| NPI Number: | 1003669110 |
| Provider Name: | JENNIFER COPENHAVER |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/09/2024 |
| Last Updated: | 04/09/2024 |
Provider Practice Location
6615 S EASTERN AVE STE 104
LAS VEGAS
NV
891193926
Practice Location Phone/Fax
| Phone: | 7027226200 |
| Fax: | 7027226202 |
Provider Mailing Location
6615 S EASTERN AVE STE 104
LAS VEGAS
NV
891193926
Provider Mailing Phone/Fax
| Phone: | 7027226200 |
| Fax: |