Basic Information
| Provider Information | |||||||||
| NPI: | 1174595292 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRAFF | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PHYSICAL THERAPIST | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7301 PEAK DR | ||||||||
| Address2: | 150 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891289037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7028040026 | ||||||||
| FaxNumber: | 7022434769 | ||||||||
| Practice Location | |||||||||
| Address1: | 7301 PEAK DR | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891289037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7029403000 | ||||||||
| FaxNumber: | 7029403004 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2006 | ||||||||
| LastUpdateDate: | 03/15/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 0785 | NV | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 1174595292 | 05 | NV | MEDICAID |