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NPI Code Detail

MEDICARE: RHEA ANN CASUPANG PT

MEDICARE: RHEA ANN CASUPANG 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 Therapist3270NV

General Provider Information

NPI Number : 1467813949
Entity Type Code : Individual
Provider Name (Legal Business Name) : RHEA ANN CASUPANG PT
Provider Business Mailing Address
First Line : 790 REMINGTON BLVD
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-4909
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4000 S EASTERN AVE STE 300
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-0826
Country : US
Telephone Number : 702-734-2732
Fax Number : 702-737-1453
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2016
Last Update Date : 03/19/2024

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Directions to “ RHEA ANN CASUPANG PT” Practice Location

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