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NPI Code Detail

MEDICARE: ANGELA LINDBERG DAVIS PTA

MEDICARE: ANGELA LINDBERG DAVIS 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
1225200000XPhysical Therapy AssistantAT-225NV

General Provider Information

NPI Number : 1124883459
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA LINDBERG DAVIS PTA
Provider Business Mailing Address
First Line : 2170 E HARMON AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-7840
Country : US
Telephone Number : 702-794-0100
Fax Number :
Provider Business Practice Location Address
First Line : 2170 E HARMON AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-7840
Country : US
Telephone Number : 702-794-0100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2024
Last Update Date : 02/15/2024

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