Provider Demographics
NPI:1316378920
Name:DESERT VALLEY THERAPY
Entity Type:Organization
Organization Name:DESERT VALLEY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-605-9080
Mailing Address - Street 1:2851 N TENAYA WAY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0435
Mailing Address - Country:US
Mailing Address - Phone:702-655-9456
Mailing Address - Fax:702-655-9594
Practice Address - Street 1:2851 N TENAYA WAY
Practice Address - Street 2:SUITE 205
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0435
Practice Address - Country:US
Practice Address - Phone:702-655-9456
Practice Address - Fax:702-655-9456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-06
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2911261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy