MEDICARE: MR. GEORGE JUNIOR TUIOTI-MARINER BA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor		NV

General Provider Information

NPI Number	:	1215232566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GEORGE JUNIOR TUIOTI-MARINER BA

Provider Business Mailing Address
First Line	:	4274 VIA DANA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-4238
Country	:	US
Telephone Number	:	702-771-9147
Fax Number	:

Provider Business Practice Location Address
First Line	:	4274 VIA DANA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-4238
Country	:	US
Telephone Number	:	702-771-9147
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2011
Last Update Date	:	01/18/2011

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Directions to “ MR. GEORGE JUNIOR TUIOTI-MARINER BA” Practice Location

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