Provider Demographics
NPI:1790354017
Name:HOVEKE, WILLIAM (LMT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:HOVEKE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3554 SIERRA PATRICIA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5811
Mailing Address - Country:US
Mailing Address - Phone:702-326-8177
Mailing Address - Fax:
Practice Address - Street 1:2860 S BRONCO ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5208
Practice Address - Country:US
Practice Address - Phone:702-326-8177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10307225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist