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General NPI Number Information
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NPI Number | 1760079412
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Entity Type | Organization
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Legal Business Name | DAYTON PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 12/29/2020
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 244 DAYTON VALLEY RD UNIT 103
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City | DAYTON
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State | NV
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Zip | 89403-8933
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Country | US
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Telephone | 752-412-8297
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Fax | 775-241-2297
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Provider Business Mailing Address
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Address Line | 2555 BLUE HAVEN LN
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City | CARSON CITY
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State | NV
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Zip | 89701-4851
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Country | US
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Telephone | 928-713-6923
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Fax | 775-747-5005
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MICAHEL CHARLES TUTTLE
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Credential | PT
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Telephone | 928-713-6923
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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 |
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License Number State |
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