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NPI Code Detail

MEDICARE: PHILLIP DIMOTSANTOS

MEDICARE: PHILLIP DIMOTSANTOS
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
1225100000XPhysical Therapist2356NV

General Provider Information

NPI Number : 1083847719
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILLIP DIMOTSANTOS
Provider Business Mailing Address
First Line : 3831 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1859
Country : US
Telephone Number : 702-876-1733
Fax Number : 702-878-2018
Provider Business Practice Location Address
First Line : 3831 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1859
Country : US
Telephone Number : 702-876-1733
Fax Number : 702-878-2018
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2009
Last Update Date : 04/16/2015

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Directions to “ PHILLIP DIMOTSANTOS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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