MEDICARE: CHYNOWETH HILL AND LEAVITT 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700878444
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHYNOWETH HILL AND LEAVITT LLC

Provider Business Mailing Address
First Line	:	3831 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1859
Country	:	US
Telephone Number	:	702-876-1733
Fax Number	:	702-878-2018

Provider Business Practice Location Address
First Line	:	921 S HIGHWAY 160
Second Line	:	STE 409
City	:	PAHRUMP
State	:	NV
Zip	:	89048-4698
Country	:	US
Telephone Number	:	775-727-3838
Fax Number	:	775-727-3781

Authorized Official
Title or Position	:	OWNER
Name	:	MR. THOMAS W CHYNOWETH SR.
Credential	:	PT
Telephone Number	:	702-876-1733

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	03/23/2009

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Directions to “CHYNOWETH HILL AND LEAVITT LLC ” Practice Location

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