Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1053756007 |
---|---|
Provider Name | Leron Morris |
First Address | North Las Vegas, NV 89081-4018 |
Second Address | North Las Vegas, NV 89081-4018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2013 |
Last Update Date | 16/03/2015 |