Provider Demographics
NPI:1619265139
Name:OATES, ELYNOR ASIDO
Entity Type:Individual
Prefix:
First Name:ELYNOR
Middle Name:ASIDO
Last Name:OATES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 THUNDER STORM AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-4868
Mailing Address - Country:US
Mailing Address - Phone:702-493-7981
Mailing Address - Fax:
Practice Address - Street 1:1930 THUNDER STORM AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-4868
Practice Address - Country:US
Practice Address - Phone:702-493-7981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-18
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner