Provider Demographics
NPI:1902233117
Name:HAMER, ANTHONY JANIERO
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:JANIERO
Last Name:HAMER
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 1:1237 W ALEXANDER RD
Mailing Address - Street 2:APARTMENT #95
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-9081
Mailing Address - Country:US
Mailing Address - Phone:702-487-0894
Mailing Address - Fax:
Practice Address - Street 1:1237 W ALEXANDER RD
Practice Address - Street 2:APARTMENT #95
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-9081
Practice Address - Country:US
Practice Address - Phone:702-487-0894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner