Provider Demographics
NPI:1073805081
Name:TERLEMEZIAN, JAMIE (BA)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:TERLEMEZIAN
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9808 HANOVER GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5763
Mailing Address - Country:US
Mailing Address - Phone:702-419-8670
Mailing Address - Fax:
Practice Address - Street 1:3047 E WARM SPRINGS RD BLDG 2
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3760
Practice Address - Country:US
Practice Address - Phone:702-419-8670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner