Provider Demographics
NPI:1003078593
Name:MORELLA, ANTHONY JOSEPH (PTA)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:MORELLA
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 W WARM SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-3586
Mailing Address - Country:US
Mailing Address - Phone:702-547-6700
Mailing Address - Fax:
Practice Address - Street 1:1500 W WARM SPRINGS RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-3586
Practice Address - Country:US
Practice Address - Phone:702-547-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-0291225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant