Provider Demographics
NPI:1386674265
Name:KRANK, DANA (MS, PT, CSCS)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:KRANK
Suffix:
Gender:M
Credentials:MS, PT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7826 SLEEPING LILY DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-8283
Mailing Address - Country:US
Mailing Address - Phone:702-476-9373
Mailing Address - Fax:702-330-0376
Practice Address - Street 1:7815 BLUE DIAMOND RD STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89178-9348
Practice Address - Country:US
Practice Address - Phone:702-476-9373
Practice Address - Fax:702-330-0376
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2283225100000X, 225100000X
WA96532251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1386674265OtherNPI
NV1386674265Medicaid
ID000010150922OtherBLUE SHIELD
NV1386674265OtherNPI
WA0198311OtherLABOR AND INDUSTRY
WA0198311OtherLABOR AND INDUSTRY