Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1033487624 |
---|---|
Provider Name | Mr. Darin M. Elquist |
First Address | Sparks, NV 89431 |
Second Address | Sparks, NV 89431-2947 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2011 |
Last Update Date | 09/12/2011 |