MEDICARE: JIM STROTHMAN

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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1508525080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIM STROTHMAN

Provider Business Mailing Address
First Line	:	1601 S RAINBOW BLVD STE 260
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-0895
Country	:	US
Telephone Number	:	970-261-5789
Fax Number	:

Provider Business Practice Location Address
First Line	:	1555 E FLAMINGO RD STE 117
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5259
Country	:	US
Telephone Number	:	970-261-5789
Fax Number	:

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

Provider Enumeration Date	:	12/13/2021
Last Update Date	:	12/13/2021

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Directions to “ JIM STROTHMAN ” Practice Location

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