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NPI Code Detail

MEDICARE: MANODNYA J VAKIL PT OCS SCS

MEDICARE: MANODNYA J VAKIL PT OCS SCS
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 Therapist1149NV

General Provider Information

NPI Number : 1134301294
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANODNYA J VAKIL PT OCS SCS
Provider Business Mailing Address
First Line : 7361 PRAIRIE FALCON RD STE 130
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0824
Country : US
Telephone Number : 702-243-0515
Fax Number : 702-243-2019
Provider Business Practice Location Address
First Line : 7361 PRAIRIE FALCON RD STE 130
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0824
Country : US
Telephone Number : 702-243-0515
Fax Number : 702-243-2019
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2007
Last Update Date : 11/30/2007

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Directions to “ MANODNYA J VAKIL PT OCS SCS” Practice Location

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