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General NPI Number Information
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NPI Number | 1164524625
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Entity Type | Individual
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Provider Name | RICHARD L BALES PT
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Gender | Male
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Dates
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Enumeration Date | 09/03/2006
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Last Update Date | 10/24/2021
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Provider Practice Location Address
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Address Line | 2110 E FLAMINGO RD STE 314
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City | LAS VEGAS
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State | NV
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Zip | 89119-5193
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Country | US
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Telephone | 702-947-5200
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Fax | 702-947-5204
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Provider Business Mailing Address
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Address Line | 2421 GOLDFIRE CIR
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City | HENDERSON
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State | NV
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Zip | 89052-2667
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Country | US
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Telephone | 702-947-5200
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Fax | 702-947-5204
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 252
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 0252
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License Number State | NV
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