MEDICARE: RODNEY PATTON QHA

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	H1400104H113186	OTHER	NV	OWNER

General Provider Information

NPI Number	:	1962791806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODNEY PATTON QHA

Provider Business Mailing Address
First Line	:	8924 SHEEP RANCH CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89143-5419
Country	:	US
Telephone Number	:	702-644-4195
Fax Number	:	702-644-5219

Provider Business Practice Location Address
First Line	:	8924 SHEEP RANCH CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89143-5419
Country	:	US
Telephone Number	:	702-644-4195
Fax Number	:	702-644-5219

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

Provider Enumeration Date	:	03/31/2011
Last Update Date	:	03/31/2011

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Directions to “ RODNEY PATTON QHA” Practice Location

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