MEDICARE: MR. FRANZ S CAMACHO P.T.

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	1796	OTHER	NV	LICENSE #

General Provider Information

NPI Number	:	1730296815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FRANZ S CAMACHO P.T.

Provider Business Mailing Address
First Line	:	2287 SMOKEY SKY DR
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-5823
Country	:	US
Telephone Number	:	702-204-9049
Fax Number	:

Provider Business Practice Location Address
First Line	:	9310 S EASTERN AVE
Second Line	:	SUITE #121
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-6843
Country	:	US
Telephone Number	:	702-897-7331
Fax Number	:	702-897-6801

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

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	07/17/2007

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