Provider Demographics
NPI:1700200672
Name:SALIMA, TOLUPENI ADILIE JR
Entity Type:Individual
Prefix:MR
First Name:TOLUPENI
Middle Name:ADILIE
Last Name:SALIMA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4080 N MARTIN L KING BLVD
Mailing Address - Street 2:SUITE 101A
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-3216
Mailing Address - Country:US
Mailing Address - Phone:702-360-9142
Mailing Address - Fax:
Practice Address - Street 1:4080 N MARTIN L KING BLVD
Practice Address - Street 2:SUITE 101A
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-3216
Practice Address - Country:US
Practice Address - Phone:702-360-9142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2822225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2822OtherPHYSICAL THERAPY