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NPI Code Detail

MEDICARE: DR. ALEXIS NICHOLE CARLSTON DPT

MEDICARE: DR. ALEXIS NICHOLE CARLSTON 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 Therapist3147NV

General Provider Information

NPI Number : 1649647652
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALEXIS NICHOLE CARLSTON DPT
Provider Business Mailing Address
First Line : 2017 SILVERTON DR
Second Line :
City : HENDERSON
State : NV
Zip : 89074-1552
Country : US
Telephone Number : 516-205-3899
Fax Number :
Provider Business Practice Location Address
First Line : 9005 S PECOS RD STE 2520
Second Line :
City : HENDERSON
State : NV
Zip : 89074-7191
Country : US
Telephone Number : 702-818-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2015
Last Update Date : 02/18/2022

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