Individual
JOHN WHALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4244 KONA COAST WAY, LAS VEGAS, NV 89121
(724) 557-2474
Mailing address
4244 KONA COAST WAY, LAS VEGAS, NV 89121-4803
(724) 557-2474
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
13-1205
NV
224Z00000X
Occupational Therapy Assistant
OP000414L
PA
Other
Enumeration date
12/19/2011
Last updated
08/03/2018
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