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General NPI Number Information
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NPI Number | 1023398328
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Entity Type | Individual
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Provider Name | LOTTY CARO PTA
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Gender | Female
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Dates
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Enumeration Date | 08/18/2011
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Last Update Date | 03/25/2016
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Provider Practice Location Address
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Address Line | 5400 S RAINBOW BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89118-1859
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Country | US
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Telephone | 702-469-6121
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Fax | 702-469-6121
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Provider Business Mailing Address
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Address Line | 6159 PINE BANKS CT
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City | LAS VEGAS
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State | NV
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Zip | 89141-8584
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 160005833
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A-0451
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | P1 60627965
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License Number State | WA
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