MEDICARE: ANTEATER PHYSICAL THERAPY AND PERFORMANCE LLC

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

General Provider Information

NPI Number	:	1588372171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANTEATER PHYSICAL THERAPY AND PERFORMANCE LLC

Provider Business Mailing Address
First Line	:	732 S 6TH ST STE N
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-6948
Country	:	US
Telephone Number	:	702-608-4279
Fax Number	:

Provider Business Practice Location Address
First Line	:	732 S 6TH ST STE N
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-6948
Country	:	US
Telephone Number	:	702-608-4279
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KELSEY CHANGSING
Credential	:	PT, DPT
Telephone Number	:	702-608-4279

Provider Enumeration Date	:	11/11/2022
Last Update Date	:	07/10/2025

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Directions to “ANTEATER PHYSICAL THERAPY AND PERFORMANCE LLC ” Practice Location

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