Provider Demographics
NPI:1508194051
Name:TOMCHEK, DAVID P (ATC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:P
Last Name:TOMCHEK
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 S MARYLAND PKWY
Mailing Address - Street 2:BOX 450007
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89154-9900
Mailing Address - Country:US
Mailing Address - Phone:702-895-3702
Mailing Address - Fax:702-895-4474
Practice Address - Street 1:4505 S MARYLAND PKWY
Practice Address - Street 2:BOX 450007
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89154-9900
Practice Address - Country:US
Practice Address - Phone:702-895-3702
Practice Address - Fax:702-895-4474
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0506078174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist