Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1013481944 |
---|---|
Provider Name | Jose Arce |
First Address | Las Vegas, NV 89130-3456 |
Second Address | Las Vegas, NV 89130-3456 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2019 |
Last Update Date | 14/01/2019 |