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NPI 1114149036

NPI 1114149036 : ANN M DOVENMUEHLER ATC : HENDERSON, NV

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General NPI Number Information
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    NPI Number           |    1114149036
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    Entity Type          |    Individual 
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    Provider Name        |    ANN M DOVENMUEHLER ATC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/02/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1615 XANADU DRIVE 
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    City                 |    HENDERSON
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    State                |    NV
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    Zip                  |    89014
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    Country              |    US
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    Telephone            |    702-547-1750
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1615 XANADU DRIVE 
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    City                 |    HENDERSON
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    State                |    NV
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    Zip                  |    89014
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    Country              |    US
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    Telephone            |    702-547-1750
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    0506004
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    License Number State |    NV
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