Provider Demographics
NPI:1558713321
Name:DARKHOVSKY, ALEXANDER (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:DARKHOVSKY
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 MCLAREN ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-0915
Mailing Address - Country:US
Mailing Address - Phone:310-382-0447
Mailing Address - Fax:
Practice Address - Street 1:9005 S PECOS RD
Practice Address - Street 2:#2520
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7190
Practice Address - Country:US
Practice Address - Phone:702-880-1515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3317225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist