Darrell Lee Banta

Individual provider Active NPI Rehabilitation Practitioner · Minden, NV

NPI 1750650800 · NPPES record last updated Dec 19, 2011

Key facts

NPI
1750650800
Entity type
Individual (NPI type 1)
Primary specialty
Rehabilitation Practitioner 225400000X
Practice address
2560 Business Pkwy
Minden, NV 89423-8985
Phone
(775) 267-9411
NPI assigned
Dec 19, 2011
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Yes

Addresses

Primary practice location

2560 Business Pkwy
Minden, NV 89423-8985

Mailing address

2560 Business Pkwy
Minden, NV 89423-8985

Other providers in Minden, NV

All providers in Minden, NV · Rehabilitation Practitioner in Nevada

Sources for this page

Verify at the official NPI Registry.