MEDICARE: SUSAN GEX PT

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	2509	NV

General Provider Information

NPI Number	:	1871863068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN GEX PT

Provider Business Mailing Address
First Line	:	7301 PEAK DR
Second Line	:	SUITE 150
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-9037
Country	:	US
Telephone Number	:	702-256-9738
Fax Number	:	702-242-5629

Provider Business Practice Location Address
First Line	:	4000 S EASTERN AVE
Second Line	:	#300
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-0824
Country	:	US
Telephone Number	:	702-734-2732
Fax Number	:	702-737-1453

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

Provider Enumeration Date	:	01/05/2012
Last Update Date	:	06/18/2013

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Directions to “ SUSAN GEX PT” Practice Location

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