Healthcare Provider Details

I. General information

NPI: 1376878702
Provider Name (Legal Business Name): CHRISTA LEE PALCHINSKY D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2009
Last Update Date: 10/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 S JONES BLVD
LAS VEGAS NV
89103-2228
US

IV. Provider business mailing address

5155 S TORREY PINES DR APT. 2096
LAS VEGAS NV
89118-0649
US

V. Phone/Fax

Practice location:
  • Phone: 702-731-0831
  • Fax: 702-737-9697
Mailing address:
  • Phone: 919-413-5052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2377
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number2377
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: