Basic Information
| Provider Information | |||||||||
| NPI: | 1316378920 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DESERT VALLEY THERAPY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2851 N TENAYA WAY | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891280435 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026559456 | ||||||||
| FaxNumber: | 7026559594 | ||||||||
| Practice Location | |||||||||
| Address1: | 2851 N TENAYA WAY | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891280435 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026559456 | ||||||||
| FaxNumber: | 7026559456 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2013 | ||||||||
| LastUpdateDate: | 12/06/2013 | ||||||||
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| AuthorizedOfficialLastName: | MILLER | ||||||||
| AuthorizedOfficialFirstName: | LIZ | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATIVE ASSISTANT | ||||||||
| AuthorizedOfficialTelephone: | 7026059080 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | 2911 | NV | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.