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General NPI Number Information
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NPI Number | 1770582462
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Entity Type | Individual
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Provider Name | TREVOR A OFFENBACKER P.T.
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Gender | Male
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Dates
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Enumeration Date | 07/15/2005
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Last Update Date | 03/05/2013
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Provider Practice Location Address
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Address Line | 1420 E CALVADA BLVD
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City | PAHRUMP
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State | NV
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Zip | 89048-3974
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Country | US
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Telephone | 775-727-4700
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Fax | 775-727-7970
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Provider Business Mailing Address
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Address Line | 3602 E SUNSET RD LAS VEGAS
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City | LAS VEGAS
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State | NV
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Zip | 89120-7202
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Country | US
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Telephone | 702-932-4308
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Fax | 702-837-8930
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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 | 1010
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License Number State | NV
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