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NPI Code Detail

MEDICARE: MR. VASHON KNOX

MEDICARE: MR. VASHON KNOX
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 : 1932419553
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. VASHON KNOX
Provider Business Mailing Address
First Line : 5405 LAVENDER CT
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-0520
Country : US
Telephone Number : 702-807-7319
Fax Number :
Provider Business Practice Location Address
First Line : 5405 LAVENDER CT
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-0520
Country : US
Telephone Number : 702-807-7319
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2010
Last Update Date : 10/16/2010

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Directions to “ MR. VASHON KNOX ” Practice Location

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