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General NPI Number Information
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NPI Number | 1356663710
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Entity Type | Individual
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Provider Name | GINGER LEI SALERA EHKE LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 02/25/2010
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Last Update Date | 04/30/2015
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Provider Practice Location Address
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Address Line | 6510 HINSON ST
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City | LAS VEGAS
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State | NV
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Zip | 89118-4413
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Country | US
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Telephone | 808-756-2130
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Fax |
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Provider Business Mailing Address
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Address Line | 11022 SAINT RAFAEL ST
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City | LAS VEGAS
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State | NV
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Zip | 89141-3808
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Country | US
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Telephone | 808-756-2130
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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 | 0506199
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License Number State | NV
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