Anthony Wayne Daugherty
Rehabilitation Practitioner in Las Vegas, NV. Individual provider (NPI-1).
NPI number1699019232
StatusActive
Last updated in NPPESNov 20, 2012
Details
- NPI
- 1699019232
- Entity type
- Individual (NPI-1)
- Name
- Mr. Anthony Wayne Daugherty
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 20, 2012
- Last updated
- Nov 20, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225400000X | Rehabilitation Practitioner | – | – | Yes |
Practice location
821 N Mojave RdLas Vegas, NV 89101-2407
Phone 702-642-7070 · Fax 702-649-3906
Mailing address
821 N Mojave RdLas Vegas, NV 89101-2407
Phone 702-642-7070 · Fax 702-649-3906
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