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NPI Code Detail

MEDICARE: SHAUN MATTHEW BEAN PT, DPT

MEDICARE: SHAUN MATTHEW BEAN 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 Therapist4943NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14943OTHERNVPHYSICAL THERAPIST LICENSE NUMBER

General Provider Information

NPI Number : 1497482699
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAUN MATTHEW BEAN PT, DPT
Provider Business Mailing Address
First Line : 6541 ZA ZU PITTS AVE UNIT 102
Second Line :
City : LAS VEGAS
State : NV
Zip : 89122-1704
Country : US
Telephone Number : 702-917-1517
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 : 08/07/2022
Last Update Date : 08/07/2022

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Directions to “ SHAUN MATTHEW BEAN PT, DPT” Practice Location

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