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NPI Code Detail

MEDICARE: EDWARD BARRO JAUCIAN PT

MEDICARE: EDWARD BARRO JAUCIAN 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 TherapistJ1-00020890DE
2225100000XPhysical Therapist4413NV

General Provider Information

NPI Number : 1669822698
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWARD BARRO JAUCIAN PT
Provider Business Mailing Address
First Line : 2550 NATURE PARK DR STE 250
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89084-3206
Country : US
Telephone Number : 702-859-4710
Fax Number : 317-388-0805
Provider Business Practice Location Address
First Line : 2550 NATURE PARK DR STE 250
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89084-3206
Country : US
Telephone Number : 702-859-9710
Fax Number : 702-859-4711
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2016
Last Update Date : 07/18/2024

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Directions to “ EDWARD BARRO JAUCIAN PT” Practice Location

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