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NPI Code Detail

MEDICARE: MEGAN R NACE D.P.T.

MEDICARE: MEGAN R NACE D.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 Therapist2474NV

General Provider Information

NPI Number : 1518272939
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN R NACE D.P.T.
Provider Business Mailing Address
First Line : 725 S HUALAPAI WAY APT 2123
Second Line :
City : LAS VEGAS
State : NV
Zip : 89145-8843
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3030 S JONES BLVD STE 105
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-6793
Country : US
Telephone Number : 702-360-1137
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2010
Last Update Date : 08/10/2010

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