MEDICARE: HEATHER FOX PT, DPT

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	3753	NV

General Provider Information

NPI Number	:	1609361914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER FOX PT, DPT

Provider Business Mailing Address
First Line	:	2420 GINGER LILY LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-6031
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7125 GRAND MONTECITO PKWY STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-0261
Country	:	US
Telephone Number	:	702-515-1540
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2018
Last Update Date	:	08/20/2020

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Directions to “ HEATHER FOX PT, DPT” Practice Location

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