Healthcare Provider Details

I. General information

NPI: 1922424340
Provider Name (Legal Business Name): AIKENHEAD PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2014
Last Update Date: 06/11/2021
Certification Date: 06/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

978 MOUNTAIN CITY HWY
ELKO NV
89801-2881
US

IV. Provider business mailing address

PO BOX 2434
ELKO NV
89803-2434
US

V. Phone/Fax

Practice location:
  • Phone: 775-738-4666
  • Fax: 775-738-4776
Mailing address:
  • Phone: 775-738-4666
  • Fax: 775-738-4776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KENDRA AIKENHEAD
Title or Position: OWNER
Credential: PT, DPT
Phone: 775-738-4666