MEDICARE: AUSTIN M OKEEFFE PTA

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	225200000X	Physical Therapy Assistant	A-0746	NV

General Provider Information

NPI Number	:	1124546023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUSTIN M OKEEFFE PTA

Provider Business Mailing Address
First Line	:	951 LAS PALMAS ENTRADA AVE APT 2115
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89012-5630
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1945 E WARM SPRINGS RD # 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4583
Country	:	US
Telephone Number	:	702-650-9266
Fax Number	:

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

Provider Enumeration Date	:	08/31/2017
Last Update Date	:	08/31/2017

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Directions to “ AUSTIN M OKEEFFE PTA” Practice Location

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