MEDICARE: KALA MARIE SANCHEZ PT, 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
1	225100000X	Physical Therapist	291803	CA
2	225100000X	Physical Therapist	PTL.0014144	CO
3	225100000X	Physical Therapist	4709	NV

General Provider Information

NPI Number	:	1194279091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALA MARIE SANCHEZ PT, DPT

Provider Business Mailing Address
First Line	:	547 RANCHO DEL SOL WAY
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-2874
Country	:	US
Telephone Number	:	508-280-0887
Fax Number	:

Provider Business Practice Location Address
First Line	:	4190 W FARM RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-5113
Country	:	US
Telephone Number	:	725-238-1197
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2016
Last Update Date	:	05/01/2023

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