Theodore Simmons III
Rehabilitation Practitioner in Las Vegas, NV. Individual provider (NPI-1).
NPI number1982155586
StatusActive
Last updated in NPPESOct 18, 2016
Details
- NPI
- 1982155586
- Entity type
- Individual (NPI-1)
- Name
- Mr. Theodore Simmons III
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 18, 2016
- Last updated
- Oct 18, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225400000X | Rehabilitation Practitioner | – | – | Yes |
Practice location
6889 S Eastern AveLas Vegas, NV 89119-4687
Phone 702-434-1200
Mailing address
6889 S Eastern AveLas Vegas, NV 89119-4687
Phone 702-434-1200
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