MEDICARE: JANINE J BIRT 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	2019	NV

General Provider Information

NPI Number	:	1740241272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANINE J BIRT DPT

Provider Business Mailing Address
First Line	:	7575 W WASHINGTON AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-4333
Country	:	US
Telephone Number	:	702-380-1515
Fax Number	:	702-380-1511

Provider Business Practice Location Address
First Line	:	7660 W CHEYENNE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-6757
Country	:	US
Telephone Number	:	702-880-1515
Fax Number	:	702-880-1511

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

Provider Enumeration Date	:	04/01/2006
Last Update Date	:	07/08/2007

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