Ethan A Adair

Individual provider Active NPI Rehabilitation Practitioner · Las Vegas, NV

NPI 1972019891 · NPPES record last updated Dec 15, 2017

Key facts

NPI
1972019891
Entity type
Individual (NPI type 1)
Primary specialty
Rehabilitation Practitioner 225400000X
Practice address
1621 E.Flamingo Rd #17 a
Las Vegas, NV 89119
Phone
(702) 333-1200
Fax
(702) 888-3196
NPI assigned
Dec 15, 2017
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 NV Yes

Addresses

Primary practice location

1621 E.Flamingo Rd #17 a
Las Vegas, NV 89119

Mailing address

1621 E.Flamingo Rd #17 a
Las Vegas, NV 89119
Phone (702) 333-1200

Other providers in Las Vegas, NV

All providers in Las Vegas, NV · Rehabilitation Practitioner in Nevada

Sources for this page

Verify at the official NPI Registry.