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General NPI Number Information
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NPI Number | 1669822698
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Entity Type | Individual
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Provider Name | EDWARD BARRO JAUCIAN PT
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Gender | Male
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Dates
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Enumeration Date | 06/21/2016
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Last Update Date | 07/18/2024
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Provider Practice Location Address
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Address Line | 2550 NATURE PARK DR STE 250
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89084-3206
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Country | US
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Telephone | 702-859-9710
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Fax | 702-859-4711
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Provider Business Mailing Address
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Address Line | 2550 NATURE PARK DR STE 250
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89084-3206
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Country | US
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Telephone | 702-859-4710
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Fax | 317-388-0805
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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 | J1-00020890
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License Number State | DE
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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 | 4413
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License Number State | NV
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