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NPI Code Detail

MEDICARE: NICHOLAS HOGAN DIBBLE DPT

MEDICARE:   NICHOLAS HOGAN DIBBLE  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
1225100000XPhysical Therapist4161NV
2225100000XPhysical TherapistPT32657FL

General Provider Information

NPI Number : 1831617695
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS HOGAN DIBBLE DPT
Provider Business Mailing Address
First Line : PO BOX 50509
Second Line :
City : HENDERSON
State : NV
Zip : 89016-0509
Country : US
Telephone Number : 702-697-7238
Fax Number : 702-732-1695
Provider Business Practice Location Address
First Line : 2800 E DESERT INN RD STE 200
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-3632
Country : US
Telephone Number : 702-294-7499
Fax Number : 702-735-0097
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2017
Last Update Date : 06/30/2020

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Directions to “ NICHOLAS HOGAN DIBBLE DPT” Practice Location

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