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NPI Code Detail

MEDICARE: PATRICK ALLEN VIADO PTA

MEDICARE:   PATRICK ALLEN VIADO  PTA
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
1225200000XPhysical Therapy AssistantA1396NV

General Provider Information

NPI Number : 1346994738
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK ALLEN VIADO PTA
Provider Business Mailing Address
First Line : 8354 STILLHOUSE CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-4674
Country : US
Telephone Number : 702-994-6008
Fax Number :
Provider Business Practice Location Address
First Line : 6823 PONDEROSA WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-2100
Country : US
Telephone Number : 702-665-4054
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2022
Last Update Date : 02/05/2022

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Directions to “ PATRICK ALLEN VIADO PTA” Practice Location

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