MEDICARE: KIM TROWER D.E.M.

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	175M00000X	Lay Midwife	1007266465	NV

General Provider Information

NPI Number	:	1619122801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM TROWER D.E.M.

Provider Business Mailing Address
First Line	:	6000 S EASTERN AVE
Second Line	:	SUITE 9A
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-3125
Country	:	US
Telephone Number	:	702-301-3385
Fax Number	:	702-269-6081

Provider Business Practice Location Address
First Line	:	6000 S EASTERN AVE
Second Line	:	SUITE 9A
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-3125
Country	:	US
Telephone Number	:	702-301-3385
Fax Number	:	702-269-6081

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

Provider Enumeration Date	:	12/01/2008
Last Update Date	:	12/01/2008

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