Provider Demographics
NPI:1225675309
Name:KANE, ELENA (PT)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:KANE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 SUGUARO BLUFFS ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-2671
Mailing Address - Country:US
Mailing Address - Phone:702-493-1228
Mailing Address - Fax:702-914-7983
Practice Address - Street 1:708 SUGUARO BLUFFS ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-2671
Practice Address - Country:US
Practice Address - Phone:702-493-1228
Practice Address - Fax:702-914-7983
Is Sole Proprietor?:No
Enumeration Date:2019-12-07
Last Update Date:2019-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0482225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist