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NPI Code Detail

MEDICARE: JASON T HENNE PT

MEDICARE: JASON T HENNE 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
1225100000XPhysical Therapist1945NV

General Provider Information

NPI Number : 1881787695
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON T HENNE PT
Provider Business Mailing Address
First Line : 6856 SCARLET FLAX ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-4830
Country : US
Telephone Number : 702-281-9265
Fax Number : 702-446-5149
Provider Business Practice Location Address
First Line : 6856 SCARLET FLAX ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-4830
Country : US
Telephone Number : 702-281-9265
Fax Number : 702-446-5149
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 01/03/2010

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Directions to “ JASON T HENNE PT” Practice Location

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