Provider Demographics
NPI:1639390834
Name:SUMMIT THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:SUMMIT THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:K
Authorized Official - Last Name:WINDOUS
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:775-289-3467
Mailing Address - Street 1:PO BOX 151674
Mailing Address - Street 2:
Mailing Address - City:ELY
Mailing Address - State:NV
Mailing Address - Zip Code:89315-1208
Mailing Address - Country:US
Mailing Address - Phone:775-289-3467
Mailing Address - Fax:
Practice Address - Street 1:1500 AVENUE H
Practice Address - Street 2:
Practice Address - City:ELY
Practice Address - State:NV
Practice Address - Zip Code:89301-2615
Practice Address - Country:US
Practice Address - Phone:775-289-3467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171W00000X
NVLLC2435-2002261QP2000X, 261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation