MEDICARE: MS. BARBARA JEAN MCDAVID B.A.

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

General Provider Information

NPI Number	:	1225364334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BARBARA JEAN MCDAVID B.A.

Provider Business Mailing Address
First Line	:	5870 W HARMON AVE
Second Line	:	APT, #248
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-4885
Country	:	US
Telephone Number	:	702-488-2199
Fax Number	:

Provider Business Practice Location Address
First Line	:	5870 W HARMON AVE
Second Line	:	APT, #248
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-4885
Country	:	US
Telephone Number	:	702-488-2199
Fax Number	:

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

Provider Enumeration Date	:	10/23/2009
Last Update Date	:	09/22/2010

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