MEDICARE: NICHOLAS DAWSON DPT

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	3821	NV

General Provider Information

NPI Number	:	1104460179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS DAWSON DPT

Provider Business Mailing Address
First Line	:	8128 APRIL BLOSSOM ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-4647
Country	:	US
Telephone Number	:	702-285-9713
Fax Number	:

Provider Business Practice Location Address
First Line	:	5840 W SUNSET RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-3449
Country	:	US
Telephone Number	:	702-967-6100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2019
Last Update Date	:	11/03/2019

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Directions to “ NICHOLAS DAWSON DPT” Practice Location

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