| NPI | 1023663572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WATERS Owner 702-300-4880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2019-08-01 |