Healthcare Provider Details

I. General information

NPI: 1073555439
Provider Name (Legal Business Name): MELISSA JENNIFER HSIEH PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA JENNIFER DELFIN PT

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 09/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8402 W CENTENNIAL PARKWAY #240
LAS VEGAS NV
89149
US

IV. Provider business mailing address

2800 E DESERT INN RD #200
LAS VEGAS NV
89121
US

V. Phone/Fax

Practice location:
  • Phone: 702-386-1250
  • Fax: 702-386-1251
Mailing address:
  • Phone: 702-892-9077
  • Fax: 702-892-9044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2012
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: