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NPI Code Detail

MEDICARE: MR. RICHARD L BALES PT

MEDICARE: MR. RICHARD L BALES PT
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 Therapist252NV
2225100000XPhysical Therapist0252NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164524625
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RICHARD L BALES PT
Provider Business Mailing Address
First Line : 2421 GOLDFIRE CIR
Second Line :
City : HENDERSON
State : NV
Zip : 89052-2667
Country : US
Telephone Number : 702-947-5200
Fax Number : 702-947-5204
Provider Business Practice Location Address
First Line : 2110 E FLAMINGO RD STE 314
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-5193
Country : US
Telephone Number : 702-947-5200
Fax Number : 702-947-5204
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2006
Last Update Date : 10/24/2021

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