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NPI Code Detail

MEDICARE: MR. THOMAS WILLIAM CHYNOWETH SR. PT

MEDICARE: MR. THOMAS WILLIAM CHYNOWETH SR. 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 Therapist0426NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00169699OTHERNVRAILROAD MEDICARE

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 : 1356333009
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. THOMAS WILLIAM CHYNOWETH SR. PT
Provider Business Mailing Address
First Line : 3831 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1859
Country : US
Telephone Number : 702-876-1733
Fax Number : 702-878-2018
Provider Business Practice Location Address
First Line : 3831 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1859
Country : US
Telephone Number : 702-876-1733
Fax Number : 702-878-2018
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2005
Last Update Date : 04/10/2008

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