Provider Demographics
NPI:1275944027
Name:THAO, JOHN (BA, CRT , RCP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:THAO
Suffix:
Gender:M
Credentials:BA, CRT , RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:4550 E CHARLESTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-5525
Mailing Address - Country:US
Mailing Address - Phone:702-785-4114
Mailing Address - Fax:702-901-4488
Practice Address - Street 1:4550 E CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-5525
Practice Address - Country:US
Practice Address - Phone:702-785-4114
Practice Address - Fax:702-901-4488
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVRC346227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified