Healthcare Provider Details

I. General information

NPI: 1972526192
Provider Name (Legal Business Name): JOSEPH INDRIERI DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8951 W SAHARA AVE SUITE 190
LAS VEGAS NV
89117-5898
US

IV. Provider business mailing address

8951 W SAHARA AVE SUITE 190
LAS VEGAS NV
89117-5898
US

V. Phone/Fax

Practice location:
  • Phone: 702-685-1607
  • Fax: 702-685-1506
Mailing address:
  • Phone: 702-685-1607
  • Fax: 702-685-1506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1815
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: