Healthcare Provider Details

I. General information

NPI: 1316615529
Provider Name (Legal Business Name): KEVIN GREGORY HOHN OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2021
Last Update Date: 09/01/2021
Certification Date: 09/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8374 W CAPOVILLA AVE
LAS VEGAS NV
89113-3305
US

IV. Provider business mailing address

105 CASCADE MEADOW CT
HENDERSON NV
89011-2544
US

V. Phone/Fax

Practice location:
  • Phone: 702-763-6174
  • Fax:
Mailing address:
  • Phone: 702-934-1853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-2362
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: