MEDICARE: MRS. LASHONA D VEASLEY

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	:	1285221861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LASHONA D VEASLEY

Provider Business Mailing Address
First Line	:	6018 SMOKE RANCH RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-3700
Country	:	US
Telephone Number	:	702-790-2977
Fax Number	:	725-251-6664

Provider Business Practice Location Address
First Line	:	6018 SMOKE RANCH RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-3700
Country	:	US
Telephone Number	:	702-790-2977
Fax Number	:	725-251-6664

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

Provider Enumeration Date	:	12/29/2020
Last Update Date	:	12/29/2020

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