Individual
BRIAN WAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
6421 TUMBLEGRASS CT, LAS VEGAS, NV 89122-3560
(702) 862-0292
Mailing address
6421 TUMBLEGRASS CT, LAS VEGAS, NV 89122-3560
(702) 862-0292
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0506252
NV
Other
Enumeration date
02/03/2015
Last updated
02/03/2015
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