MEDICARE: MR. ERIC WILLIAM GAHAN ATC

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	2255A2300X	Athletic Trainer	1945	MA

General Provider Information

NPI Number	:	1942264528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ERIC WILLIAM GAHAN ATC

Provider Business Mailing Address
First Line	:	901 ROYAL AMETHYST WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-2432
Country	:	US
Telephone Number	:	617-694-3813
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 ROYAL AMETHYST WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-2432
Country	:	US
Telephone Number	:	617-694-3813
Fax Number	:

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

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	01/07/2022

Similar Medicare Providers

1043838204 — TIFFANY MOTLEY
Practice Location Address:

852 ROYAL AMETHYST WAY
LAS VEGAS, NV
89178-2432

Practice Phone: 702-545-8811
Practice Fax:

1720596083 — MAURICE THOMAS
Practice Location Address:

1351 W OWENS AVE
LAS VEGAS, NV
89106-2432

Practice Phone: 702-344-7990
Practice Fax:

1871091769 — ADVANCE PROFESSIONAL BEHAVIORAL SERVICES
Practice Location Address:

1351 W OWENS AVE
LAS VEGAS, NV
89106-2432

Practice Phone: 702-636-3900
Practice Fax:

1407477177 — KENIESHA ANDREA CROCKETT
Practice Location Address:

2432 MORTON AVE APT C
NORTH LAS VEGAS, NV
89032-4790

Practice Phone: 702-285-4749
Practice Fax:

1376159210 — MIND POWER BEHAVIORAL SERVICES LLC
Practice Location Address:

1363 W OWENS AVE
LAS VEGAS, NV
89106-2432

Practice Phone: 702-272-2777
Practice Fax:

1174295042 — ENIGMA LLC
Practice Location Address:

2432 SHADY VISTA DR
LAS VEGAS, NV
89134-0191

Practice Phone: 718-986-3133
Practice Fax:

Directions to “ MR. ERIC WILLIAM GAHAN ATC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.