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NPI Code Detail

MEDICARE: DONTE RAY JASAMES

MEDICARE:   DONTE RAY JASAMES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1124373527
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONTE RAY JASAMES
Provider Business Mailing Address
First Line : 5079 W MOBERLY AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89139-0142
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5079 W MOBERLY AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89139-0142
Country : US
Telephone Number : 702-526-3073
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2012
Last Update Date : 07/21/2012

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Directions to “ DONTE RAY JASAMES ” Practice Location

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