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NPI Code Detail

MEDICARE: GABRIEL MERCER PTA

MEDICARE: GABRIEL MERCER PTA
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
1225200000XPhysical Therapy AssistantA-1340NV

General Provider Information

NPI Number : 1538747704
Entity Type Code : Individual
Provider Name (Legal Business Name) : GABRIEL MERCER PTA
Provider Business Mailing Address
First Line : 7189 ADVANCED WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-3691
Country : US
Telephone Number : 702-777-7050
Fax Number :
Provider Business Practice Location Address
First Line : 7189 ADVANCED WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-3691
Country : US
Telephone Number : 702-613-3780
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2021
Last Update Date : 03/30/2021

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Directions to “ GABRIEL MERCER PTA” Practice Location

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