MEDICARE: MARIE LOUISE PALU PT

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	539	NV

General Provider Information

NPI Number	:	1093764094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE LOUISE PALU PT

Provider Business Mailing Address
First Line	:	PO BOX 4386
Second Line	:
City	:	INCLINE VILLAGE
State	:	NV
Zip	:	89450-4386
Country	:	US
Telephone Number	:	775-833-1900
Fax Number	:	775-833-0889

Provider Business Practice Location Address
First Line	:	797 SOUTHWOOD BLVD
Second Line	:	# 3
City	:	INCLINE VILLAGE
State	:	NV
Zip	:	89451-9484
Country	:	US
Telephone Number	:	775-833-1900
Fax Number	:	775-833-0889

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

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	07/09/2007

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Directions to “ MARIE LOUISE PALU PT” Practice Location

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