MEDICARE: MR. RODNEY DEMETRIUS YERGER CRT

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	2278G1100X	General Care Certified Respiratory Therapist	RC589	NV

General Provider Information

NPI Number	:	1881873636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RODNEY DEMETRIUS YERGER CRT

Provider Business Mailing Address
First Line	:	2701 N TENAYA WAY STE 290
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1406
Country	:	US
Telephone Number	:	702-869-4401
Fax Number	:	702-869-9904

Provider Business Practice Location Address
First Line	:	2701 N TENAYA WAY STE 290
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1406
Country	:	US
Telephone Number	:	702-869-4401
Fax Number	:	702-869-9904

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

Provider Enumeration Date	:	10/29/2007
Last Update Date	:	10/29/2007

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