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NPI Code Detail

MEDICARE: MARISA HURT P.T., D.P.T

MEDICARE: MARISA HURT P.T., D.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
12251P0200XPediatric Physical Therapist2900NV

General Provider Information

NPI Number : 1740618446
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISA HURT P.T., D.P.T
Provider Business Mailing Address
First Line : 7361 PRAIRIE FALCON RD STE 130
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0824
Country : US
Telephone Number : 702-804-1511
Fax Number : 702-804-2551
Provider Business Practice Location Address
First Line : 7361 PRAIRIE FALCON RD STE 130
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0824
Country : US
Telephone Number : 702-804-1511
Fax Number : 702-804-2551
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2013
Last Update Date : 10/16/2013

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