Provider Demographics
NPI:1629343629
Name:ACTION THERAPEUTICS LLC
Entity Type:Organization
Organization Name:ACTION THERAPEUTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:REAGOR
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:702-545-0555
Mailing Address - Street 1:2629 W HORIZON RIDGE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2804
Mailing Address - Country:US
Mailing Address - Phone:702-545-0555
Mailing Address - Fax:702-434-8985
Practice Address - Street 1:2629 W HORIZON RIDGE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2804
Practice Address - Country:US
Practice Address - Phone:702-545-0555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2006225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty