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General NPI Number Information
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NPI Number | 1255900544
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Entity Type | Individual
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Provider Name | NICOLE GENSOLIN JALANDONI PT
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Gender | Female
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Dates
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Enumeration Date | 06/21/2021
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 2820 W CHARLESTON BLVD STE 1
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City | LAS VEGAS
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State | NV
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Zip | 89102-1942
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Country | US
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Telephone | 725-726-7847
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Fax | 725-726-7876
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Provider Business Mailing Address
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Address Line | 2820 W CHARLESTON BLVD STE 1
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City | LAS VEGAS
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State | NV
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Zip | 89102-1942
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Country | US
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Telephone | 725-726-7847
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Fax | 725-726-7876
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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 | 047259
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 6379
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License Number State | NV
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