Jefferson Keyes

Individual provider Active NPI Speech-Language Pathologist · Fallon, NV

NPI 1134566987 · NPPES record last updated Jun 3, 2013

Key facts

NPI
1134566987
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
1387 (NV)
Practice address
550 N Sherman St
Fallon, NV 89406-3488
Phone
(775) 423-7800
NPI assigned
Jun 3, 2013
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1387NVMDOrthopedic Physical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1387 NV Yes

Addresses

Primary practice location

550 N Sherman St
Fallon, NV 89406-3488

Mailing address

3034 Chilcoot Dr
Sparks, NV 89434-1794

Other providers in Fallon, NV

All providers in Fallon, NV · Speech-Language Pathologist in Nevada

Sources for this page

Verify at the official NPI Registry.