Provider Demographics
NPI:1992474357
Name:LAIRD, DAVID NATHAN (OTR/L)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:NATHAN
Last Name:LAIRD
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10837 HUNTERS GREEN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89166-5115
Mailing Address - Country:US
Mailing Address - Phone:702-800-8860
Mailing Address - Fax:
Practice Address - Street 1:3391 N BUFFALO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-6283
Practice Address - Country:US
Practice Address - Phone:702-800-8860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15-0625225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist