Provider Demographics
NPI:1639471378
Name:JOBE, BRIAN (AS)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:
Last Name:JOBE
Suffix:
Gender:M
Credentials:AS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 NAPOLEON DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89156-7187
Mailing Address - Country:US
Mailing Address - Phone:702-438-8452
Mailing Address - Fax:702-438-2981
Practice Address - Street 1:1941 NAPOLEON DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89156-7187
Practice Address - Country:US
Practice Address - Phone:702-438-8452
Practice Address - Fax:702-438-2981
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner