Provider Demographics
NPI:1710633888
Name:WEBSTER, JAMES DANIEL
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DANIEL
Last Name:WEBSTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 CLOUD DANCE CT
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-1667
Mailing Address - Country:US
Mailing Address - Phone:818-233-7588
Mailing Address - Fax:
Practice Address - Street 1:1617 CLOUD DANCE CT
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-1667
Practice Address - Country:US
Practice Address - Phone:818-233-7588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-26
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner