NPI 1033173372

Jay Dee Mellette, ATC

Practitioner Athletic Trainer Las Vegas, NV

Practice location

Address: 980 Kelly Johnson Dr, Las Vegas, NV 89119-3785
Phone: (702) 352-0200
Fax: (702) 891-1707
Mailing address: 7123 S Durango Dr Unit 303, Las Vegas, NV 89113-2064

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 0506040 (NV)

Other Specialist/Technologist providers in Nevada →

Registry record

NPI: 1033173372
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Apr 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.