MEDICARE: CHRISTOPHER MASSA PT, 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	40QA01628500	NJ
2	225100000X	Physical Therapist	4671	NV

General Provider Information

NPI Number	:	1740658285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER MASSA PT, DPT

Provider Business Mailing Address
First Line	:	8374 W CAPOVILLA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3305
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8374 W CAPOVILLA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-3305
Country	:	US
Telephone Number	:	800-967-4667
Fax Number	:

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

Provider Enumeration Date	:	09/14/2015
Last Update Date	:	09/29/2021

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Directions to “ CHRISTOPHER MASSA PT, DPT” Practice Location

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