Provider Demographics
NPI:1477890572
Name:ZIMMERMAN, WESLEY R (CST/CSFA)
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:R
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:CST/CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 N TENAYA WAY STE 301
Mailing Address - Street 2:NEVADA ORTHOPEDIC & SPINE CENTER
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-1112
Mailing Address - Country:US
Mailing Address - Phone:702-878-0393
Mailing Address - Fax:702-938-0137
Practice Address - Street 1:2650 N TENAYA WAY STE 301
Practice Address - Street 2:NEVADA ORTHOPEDIC & SPINE CENTER
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-1112
Practice Address - Country:US
Practice Address - Phone:702-878-0393
Practice Address - Fax:702-938-0137
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant