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General NPI Number Information
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NPI Number | 1639841737
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Entity Type | Individual
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Provider Name | ALISA SWEENEY MEDICAL TECHICHAN
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Gender | Female
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Dates
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Enumeration Date | 09/28/2021
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Last Update Date | 09/28/2021
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Provider Practice Location Address
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Address Line | 2755 E DESERT INN RD STE 240
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City | LAS VEGAS
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State | NV
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Zip | 89121-3610
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Country | US
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Telephone | 725-204-7528
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Fax |
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Provider Business Mailing Address
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Address Line | 7053 SOLANA RIDGE DR
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89084-2536
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Country | US
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Telephone | 714-815-5944
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number |
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License Number State | NV
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