MEDICARE: SHIRLEY GAW RPT

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	PT - 1958	NV
2	2251C2600X	Cardiopulmonary Physical Therapist	PT - 1958	NV
3	2251E1200X	Ergonomics Physical Therapist	PT - 1958	NV
4	2251E1300X	Clinical Electrophysiology Physical Therapist	PT - 1958	NV
5	2251G0304X	Geriatric Physical Therapist	PT - 1958	NV
6	2251N0400X	Neurology Physical Therapist	PT - 1958	NV
7	2251P0200X	Pediatric Physical Therapist	PT - 1958	NV
8	2251X0800X	Orthopedic Physical Therapist	PT - 1958	NV

General Provider Information

NPI Number	:	1689996720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIRLEY GAW RPT

Provider Business Mailing Address
First Line	:	7975 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7942
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7975 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7942
Country	:	US
Telephone Number	:	702-617-4470
Fax Number	:

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

Provider Enumeration Date	:	02/16/2010
Last Update Date	:	01/31/2012

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Directions to “ SHIRLEY GAW RPT” Practice Location

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