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General NPI Number Information
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NPI Number | 1427379148
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Entity Type | Organization
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Legal Business Name | MML PHYSICAL THERAPY GROUP INC
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Dates
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Enumeration Date | 06/16/2010
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Last Update Date | 10/24/2016
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Provider Practice Location Address
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Address Line | 600 S TONOPAH DR SUITE 350
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City | LAS VEGAS
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State | NV
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Zip | 89106-4025
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Country | US
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Telephone | 702-384-6330
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Fax | 702-384-2668
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Provider Business Mailing Address
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Address Line | 600 S TONOPAH DR SUITE 350
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City | LAS VEGAS
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State | NV
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Zip | 89106-4025
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Country | US
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Telephone | 702-384-6330
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Fax | 702-384-2668
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Authorized Official
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Title or Position | OWNER
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Name | KAREN CRAWFORD
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Credential | PT
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Telephone | 702-384-6330
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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 | 0675
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License Number State | NV
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