MEDICARE: LAS VEGAS WEST INC

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	208100000X	Physical Medicine & Rehabilitation Physician	PT1469	NV

General Provider Information

NPI Number	:	1528291010
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAS VEGAS WEST INC

Provider Business Mailing Address
First Line	:	8751 W CHARLESTON BLVD STE 250
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-5484
Country	:	US
Telephone Number	:	604-599-1895
Fax Number	:	604-599-1891

Provider Business Practice Location Address
First Line	:	8751 W CHARLESTON BLVD STE 250
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-5484
Country	:	US
Telephone Number	:	604-599-1895
Fax Number	:	604-599-1891

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MR. PAUL ROTHWELL
Credential	:
Telephone Number	:	604-599-1895

Provider Enumeration Date	:	08/31/2009
Last Update Date	:	08/31/2009

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Directions to “LAS VEGAS WEST INC ” Practice Location

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