MEDICARE: CHANHA HWANG LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1063293116
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHANHA HWANG LLC

Provider Business Mailing Address
First Line	:	2633 S DURANGO DR APT 201
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2668
Country	:	US
Telephone Number	:	702-268-5090
Fax Number	:

Provider Business Practice Location Address
First Line	:	2633 S DURANGO DR APT 201
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2668
Country	:	US
Telephone Number	:	702-268-5090
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	MR. CHANHA HWANG
Credential	:	PT
Telephone Number	:	702-268-5090

Provider Enumeration Date	:	10/12/2023
Last Update Date	:	10/12/2023

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Directions to “CHANHA HWANG LLC ” Practice Location

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