MEDICARE: ERIN BRADY KING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2164	NV

General Provider Information

NPI Number	:	1063678522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN BRADY KING

Provider Business Mailing Address
First Line	:	9050 W WARM SPRINGS RD
Second Line	:	2136
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-3826
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9050 W WARM SPRINGS RD
Second Line	:	2136
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-3826
Country	:	US
Telephone Number	:	315-430-8557
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2008
Last Update Date	:	09/15/2022

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Directions to “ ERIN BRADY KING ” Practice Location

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