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NPI Code Detail

MEDICARE: MS. SUZANNE DAVIS QHMA

MEDICARE: MS. SUZANNE DAVIS QHMA
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1689979940
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUZANNE DAVIS QHMA
Provider Business Mailing Address
First Line : 3255 CASEY DR APT 202
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-1164
Country : US
Telephone Number : 702-622-6424
Fax Number :
Provider Business Practice Location Address
First Line : 5150 S PECOS RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-1237
Country : US
Telephone Number : 702-483-5919
Fax Number : 702-483-5546
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2011
Last Update Date : 02/24/2011

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