MEDICARE: DR. SHELLY PAIGE SANTORO 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	1636	NV

Other Identifiers

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

General Provider Information

NPI Number	:	1215907241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHELLY PAIGE SANTORO DPT

Provider Business Mailing Address
First Line	:	12056 ALZINA CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89138-1100
Country	:	US
Telephone Number	:	702-406-0128
Fax Number	:

Provider Business Practice Location Address
First Line	:	8020 W SAHARA AVE STE 160
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7917
Country	:	US
Telephone Number	:	702-595-5437
Fax Number	:

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

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	07/06/2024

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