Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | B00386 | NV |
NPI | 1740435239 |
---|---|
Provider Name | Rodney Perry |
First Address | Las Vegas, NV 89117-1635 |
Second Address | Las Vegas, NV 89117-1635 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2008 |
Last Update Date | 25/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U34000 | (02) | NV |