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NPI Code Detail

MEDICARE: SARAH KAY BUCKENDAHL PT, MPT, GCS

MEDICARE: SARAH KAY BUCKENDAHL PT, MPT, GCS
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 Therapist2186NV

General Provider Information

NPI Number : 1922287937
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH KAY BUCKENDAHL PT, MPT, GCS
Provider Business Mailing Address
First Line : PO BOX 69
Second Line :
City : MESQUITE
State : NV
Zip : 89024-0069
Country : US
Telephone Number : 702-346-3105
Fax Number :
Provider Business Practice Location Address
First Line : 210 N SANDHILL BLVD
Second Line : SUITE B
City : MESQUITE
State : NV
Zip : 89027-4789
Country : US
Telephone Number : 702-346-3105
Fax Number : 702-346-3544
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2007
Last Update Date : 10/25/2007

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