Healthcare Provider Details

I. General information

NPI: 1457091597
Provider Name (Legal Business Name): KAITLIN AVA-MARIE LANDIER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1489 W WARM SPRINGS RD STE 110
HENDERSON NV
89014-7367
US

IV. Provider business mailing address

1489 W WARM SPRINGS RD STE 110
HENDERSON NV
89014-7367
US

V. Phone/Fax

Practice location:
  • Phone: 702-419-6356
  • Fax:
Mailing address:
  • Phone: 702-419-6356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3686
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: