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NPI Code Detail

MEDICARE: MR. MATHEW ROOS SMITH PT

MEDICARE: MR. MATHEW ROOS SMITH PT
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
1225100000XPhysical Therapist0329NV

General Provider Information

NPI Number : 1093787111
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MATHEW ROOS SMITH PT
Provider Business Mailing Address
First Line : 10785 W TWAIN AVE STE 223
Second Line :
City : LAS VEGAS
State : NV
Zip : 89135-3028
Country : US
Telephone Number : 725-726-7847
Fax Number :
Provider Business Practice Location Address
First Line : 727 N NELLIS BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-5384
Country : US
Telephone Number : 725-726-7847
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2006
Last Update Date : 10/23/2020

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Directions to “ MR. MATHEW ROOS SMITH PT” Practice Location

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