Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | CPO 3298 |
NPI | 1063759421 |
---|---|
Provider Name | David A Kovach |
First Address | Henderson, NV 89014-2611 |
Second Address | Henderson, NV 89014-2657 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2013 |
Last Update Date | 03/01/2021 |