Provider Demographics
NPI:1881031714
Name:THROWER, MICHAEL DEON
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DEON
Last Name:THROWER
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 1:5070 VEGAS VALLEY DR
Mailing Address - Street 2:# 621703
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89142-2556
Mailing Address - Country:US
Mailing Address - Phone:702-290-7086
Mailing Address - Fax:
Practice Address - Street 1:5070 VEGAS VALLEY DR
Practice Address - Street 2:# 621703
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89142-2556
Practice Address - Country:US
Practice Address - Phone:702-290-7086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-01
Last Update Date:2013-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst