Provider Demographics
NPI:1508996018
Name:ASCENT SPORTS THERAPY LLC
Entity Type:Organization
Organization Name:ASCENT SPORTS THERAPY LLC
Other - Org Name:ASCENT PHYSCIAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER-MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:775-885-9965
Mailing Address - Street 1:3246 N CARSON ST
Mailing Address - Street 2:SUITE # 120
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-0106
Mailing Address - Country:US
Mailing Address - Phone:775-885-9965
Mailing Address - Fax:775-885-9969
Practice Address - Street 1:3246 N CARSON ST
Practice Address - Street 2:SUITE # 120
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-0106
Practice Address - Country:US
Practice Address - Phone:775-885-9965
Practice Address - Fax:775-885-9969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV34664Medicare PIN