Healthcare Provider Details

I. General information

NPI: 1598832115
Provider Name (Legal Business Name): PHYSIOTHERAPY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 12/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 E FLAMINGO RD #103
LAS VEGAS NV
89121-5069
US

IV. Provider business mailing address

6263 POPLAR AVE STE. 801
MEMPHIS TN
38119-4701
US

V. Phone/Fax

Practice location:
  • Phone: 702-737-0304
  • Fax: 702-733-9895
Mailing address:
  • Phone: 901-685-7227
  • Fax: 267-321-2079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DENNIS FITZPATRICK
Title or Position: CFO
Credential:
Phone: 610-644-7824