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NPI Code Detail

MEDICARE: RAYMOND GAMBLE

MEDICARE:   RAYMOND  GAMBLE
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 : 1942572508
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAYMOND GAMBLE
Provider Business Mailing Address
First Line : 3535 MERCURY ST
Second Line : APT G
City : NORTH LAS VEGAS
State : NV
Zip : 89030-4540
Country : US
Telephone Number : 702-401-7348
Fax Number :
Provider Business Practice Location Address
First Line : 3535 MERCURY ST
Second Line : APT G
City : NORTH LAS VEGAS
State : NV
Zip : 89030-4540
Country : US
Telephone Number : 702-401-7348
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2012
Last Update Date : 01/29/2012

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Directions to “ RAYMOND GAMBLE ” Practice Location

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