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NPI Code Detail

MEDICARE: ROSEMARY JO-MEI ODDERS DPT

MEDICARE: ROSEMARY JO-MEI ODDERS 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 Therapist2412NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700932878
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSEMARY JO-MEI ODDERS DPT
Provider Business Mailing Address
First Line : 3213 W CHARLESTON BLVD
Second Line : STE 105
City : LAS VEGAS
State : NV
Zip : 89102-1991
Country : US
Telephone Number : 702-235-6017
Fax Number :
Provider Business Practice Location Address
First Line : 3213 W CHARLESTON BLVD
Second Line : STE 105
City : LAS VEGAS
State : NV
Zip : 89102-1991
Country : US
Telephone Number : 702-570-6222
Fax Number : 702-570-6234
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2007
Last Update Date : 11/04/2016

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Directions to “ ROSEMARY JO-MEI ODDERS DPT” Practice Location

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