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NPI Code Detail

MEDICARE: JERMAINE JOSHUA DANFORD

MEDICARE: JERMAINE JOSHUA DANFORD
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 PractitionerNV

General Provider Information

NPI Number : 1730521782
Entity Type Code : Individual
Provider Name (Legal Business Name) : JERMAINE JOSHUA DANFORD
Provider Business Mailing Address
First Line : 2401 W BONANZA RD
Second Line : STE L
City : LAS VEGAS
State : NV
Zip : 89106-4774
Country : US
Telephone Number : 702-581-4817
Fax Number : 702-359-0041
Provider Business Practice Location Address
First Line : 2401 W BONANZA RD
Second Line : STE L
City : LAS VEGAS
State : NV
Zip : 89106-4774
Country : US
Telephone Number : 702-581-4817
Fax Number : 702-359-0041
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2013
Last Update Date : 07/18/2013

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Directions to “ JERMAINE JOSHUA DANFORD ” Practice Location

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