Healthcare Provider Details

I. General information

NPI: 1922650373
Provider Name (Legal Business Name): PAUL WOYTUS PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2019
Last Update Date: 10/04/2021
Certification Date: 10/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N BUFFALO DR STE 100
LAS VEGAS NV
89145-0397
US

IV. Provider business mailing address

2821 W. HORIZON RIDGE PKWY SUITE #101
HENDERSON NV
89052
US

V. Phone/Fax

Practice location:
  • Phone: 702-818-5000
  • Fax:
Mailing address:
  • Phone: 702-893-3333
  • Fax: 702-893-0960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4059
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: