MEDICARE: FULL FUNCTION PHYSICAL THERAPY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	163WM1400X	Nurse Massage Therapist (NMT)
2	225200000X	Physical Therapy Assistant
3	225700000X	Massage Therapist
4	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1043955099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FULL FUNCTION PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	124 SOARING SKY AVE
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89011-2535
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2250 CORPORATE CIR STE 350
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-7714
Country	:	US
Telephone Number	:	702-522-7858
Fax Number	:	702-522-7897

Authorized Official
Title or Position	:	CREDENTIALER
Name	:	SANDY FRIDAY
Credential	:
Telephone Number	:	702-800-8988

Provider Enumeration Date	:	05/04/2022
Last Update Date	:	08/12/2022

Similar Medicare Providers

1174800098 — MR. JARED TRAVIS MORASCO D.P.T.
Practice Location Address:

2250 CORPORATE CIR STE 350
HENDERSON, NV
89074-7714

Practice Phone: 702-800-8988
Practice Fax:

1518397611 — BART TAYLOR PT
Practice Location Address:

2250 CORPORATE CIR STE 350
HENDERSON, NV
89074-7714

Practice Phone: 702-800-8988
Practice Fax:

1437697430 — AHC OF HENDERSON LLC
Practice Location Address:

1285 EAST CACTUS AVENUE
HENDERSON, NV
89183-7714

Practice Phone: 702-790-6300
Practice Fax: 702-790-6350

1801330998 — SPIRIT SEELEY RN, MMP
Practice Location Address:

2481 W HORIZON RIDGE PKWY STE 100
HENDERSON, NV
89052-5926

Practice Phone: 562-537-8517
Practice Fax:

1932180973 — LISA MARY GALL NP
Practice Location Address:

35294 LOGAN LN
HILLMAN, MN
56338-2445

Practice Phone: 320-277-3078
Practice Fax:

1154263580 — ADDISON MOSES
Practice Location Address:

2520 SAINT ROSE PKWY
HENDERSON, NV
89074-7783

Practice Phone: 301-697-9425
Practice Fax:

Directions to “FULL FUNCTION PHYSICAL THERAPY, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.