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NPI Code Detail

MEDICARE: AARON CLARK

MEDICARE: AARON CLARK
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
1225200000XPhysical Therapy AssistantA-0755NV

General Provider Information

NPI Number : 1710374939
Entity Type Code : Individual
Provider Name (Legal Business Name) : AARON CLARK
Provider Business Mailing Address
First Line : 10442 MOUNT WASHINGTON AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89166-5057
Country : US
Telephone Number : 720-232-6512
Fax Number :
Provider Business Practice Location Address
First Line : 6351 N FORT APACHE RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-2300
Country : US
Telephone Number : 702-515-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2015
Last Update Date : 04/26/2015

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Directions to “ AARON CLARK ” Practice Location

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