Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1003114984 |
---|---|
Provider Name | Roderick Hill |
First Address | North Las Vegas, NV 89031-0766 |
Second Address | North Las Vegas, NV 89031-0766 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2011 |
Last Update Date | 17/08/2011 |