Individual
DANIEL E MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2496 W CHARLESTON BLVD, LAS VEGAS, NV 89102-2179
(702) 310-3722
(702) 310-3722
Mailing address
2496 W CHARLESTON BLVD, LAS VEGAS, NV 89102-2179
(702) 310-3722
(702) 310-3722
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
310
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ITIN
—
NE
Enumeration date
08/30/2021
Last updated
08/30/2021
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