MEDICARE: INSPIRED CARE REHABILITATION GROUP LLC

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	208100000X	Physical Medicine & Rehabilitation Physician	7285	NV

General Provider Information

NPI Number	:	1154756815
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSPIRED CARE REHABILITATION GROUP LLC

Provider Business Mailing Address
First Line	:	7906 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1990
Country	:	US
Telephone Number	:	702-307-1800
Fax Number	:

Provider Business Practice Location Address
First Line	:	7906 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1990
Country	:	US
Telephone Number	:	702-307-1800
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	TONY CHIN
Credential	:	MD
Telephone Number	:	702-307-1800

Provider Enumeration Date	:	09/12/2013
Last Update Date	:	09/12/2013

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