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NPI Code Detail

MEDICARE: JENA M ESPINOSA DPT

MEDICARE: JENA M ESPINOSA DPT
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 Therapist1631ND

General Provider Information

NPI Number : 1174886543
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENA M ESPINOSA DPT
Provider Business Mailing Address
First Line : 11091 KILKERRAN CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89141-4356
Country : US
Telephone Number : 702-381-1839
Fax Number :
Provider Business Practice Location Address
First Line : 11091 KILKERRAN CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89141-4356
Country : US
Telephone Number : 702-381-1839
Fax Number : 701-751-1657
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2012
Last Update Date : 10/17/2022

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