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NPI Code Detail

MEDICARE: JAMIE BROPHY P.T.

MEDICARE: JAMIE BROPHY P.T.
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 Therapist1893NV

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 : 1205012051
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE BROPHY P.T.
Provider Business Mailing Address
First Line : 848 N RAINBOW BLVD
Second Line : BOX 357
City : LAS VEGAS
State : NV
Zip : 89107-1103
Country : US
Telephone Number : 702-256-9738
Fax Number : 702-242-5629
Provider Business Practice Location Address
First Line : 1525 E WINDMILL LN
Second Line : STE 202
City : LAS VEGAS
State : NV
Zip : 89123-1902
Country : US
Telephone Number : 702-434-6920
Fax Number : 702-434-1524
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2008
Last Update Date : 05/23/2008

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