Individual
MR. DEWITT J. PAUL III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C. PED
Contact information
Practice address
10520 S EASTERN AVE # 100, HENDERSON, NV 89052-3900
(702) 838-8111
(702) 838-8115
Mailing address
10520 S EASTERN AVE # 100, HENDERSON, NV 89052-3900
(702) 838-8111
(702) 838-8115
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
MP00225
NV
335E00000X
Prosthetic/Orthotic Supplier
MP00225
NV
Other
Enumeration date
02/15/2012
Last updated
02/15/2012
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