Provider Demographics
NPI:1467467241
Name:GANZ, KARL S (PT)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:S
Last Name:GANZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3121 S MARYLAND PARKWAY
Mailing Address - Street 2:SUITE 612
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109
Mailing Address - Country:US
Mailing Address - Phone:702-734-6114
Mailing Address - Fax:702-734-8457
Practice Address - Street 1:8440 WEST LAKE MEAD BLVD
Practice Address - Street 2:SUITE 111
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128
Practice Address - Country:US
Practice Address - Phone:702-363-9000
Practice Address - Fax:702-363-1978
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV0642225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV37139Medicare ID - Type Unspecified