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NPI Code Detail

MEDICARE: DR. MINIJA EDGAR PT, DPT

MEDICARE: DR. MINIJA EDGAR PT, DPT
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 Therapist6943NV

General Provider Information

NPI Number : 1487386983
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MINIJA EDGAR PT, DPT
Provider Business Mailing Address
First Line : 1809 SHIREWICK DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-5360
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7381 PRAIRIE FALCON RD STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0812
Country : US
Telephone Number : 702-389-1950
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2022
Last Update Date : 05/11/2026

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