MEDICARE: KRANK ENTERPRISES, LLC

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	261QP2000X	Physical Therapy Clinic/Center
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1932827797
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KRANK ENTERPRISES, LLC

Provider Business Mailing Address
First Line	:	7826 SLEEPING LILY DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-8283
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7815 BLUE DIAMOND RD STE 102
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-9348
Country	:	US
Telephone Number	:	702-476-9373
Fax Number	:	702-330-0376

Authorized Official
Title or Position	:	OWNER
Name	:	DANA KRANK
Credential	:	DPT
Telephone Number	:	208-651-6284

Provider Enumeration Date	:	08/18/2022
Last Update Date	:	01/12/2024

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