Provider Demographics
NPI:1033687066
Name:PEREZ, JOSHUA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 E PRATER WAY STE 103
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-8973
Mailing Address - Country:US
Mailing Address - Phone:775-331-1199
Mailing Address - Fax:775-331-1180
Practice Address - Street 1:1610 ROBB DR STE D5
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-3520
Practice Address - Country:US
Practice Address - Phone:775-746-9222
Practice Address - Fax:775-746-9224
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4388225100000X
GAPT013768225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist