Healthcare Provider Details

I. General information

NPI: 1528674025
Provider Name (Legal Business Name): CELINE LISA ESKANDARI PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2020
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2870 BICENTENNIAL PKWY STE 100
HENDERSON NV
89044-4481
US

IV. Provider business mailing address

1710 W HORIZON RIDGE PKWY STE 110
HENDERSON NV
89012-4901
US

V. Phone/Fax

Practice location:
  • Phone: 702-483-3669
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4381
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: