Sandra Catherine Tavisora, NCTM

NPI #1376725648 in N Las Vegas, Nevada

Provider Information

NPI Number: 1376725648
Entity Type: Individual
Name: Sandra Catherine Tavisora, NCTM
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: NCTM
Enumeration Date: Nov 28, 2007
Last Updated: Dec 19, 2007

Practice Location

Address: 6961 PUETOLLANO DR
City: N Las Vegas
State: Nevada
ZIP Code: 89084-2339
Phone: (480) 650-2010

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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