MEDICARE: SEAN REEDER

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
1	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1528553237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN REEDER

Provider Business Mailing Address
First Line	:	3920 W ANN RD STE 100
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-3840
Country	:	US
Telephone Number	:	702-550-6700
Fax Number	:	702-550-4872

Provider Business Practice Location Address
First Line	:	4033 GRANT HILL AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-6648
Country	:	US
Telephone Number	:	702-550-6700
Fax Number	:	702-550-4872

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2018
Last Update Date	:	06/25/2018

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