Provider Demographics
NPI:1114972973
Name:PACE PHYSICAL THERAPY & SPINE FITNESS
Entity Type:Organization
Organization Name:PACE PHYSICAL THERAPY & SPINE FITNESS
Other - Org Name:LAURIE E NEMES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:NEMES
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT MOMT
Authorized Official - Phone:702-255-7223
Mailing Address - Street 1:911 NORTH BUFFALO DR
Mailing Address - Street 2:STE 107
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0380
Mailing Address - Country:US
Mailing Address - Phone:702-255-7223
Mailing Address - Fax:702-255-6211
Practice Address - Street 1:911 NORTH BUFFALO DR
Practice Address - Street 2:STE 107
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0380
Practice Address - Country:US
Practice Address - Phone:702-255-7223
Practice Address - Fax:702-255-6211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0506225100000X
NV1512225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX ID
=========OtherTAX ID