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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Las Vegas, NV · Rehabilitation Practitioner in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.