Provider Demographics
NPI:1740241272
Name:BIRT, JANINE J (DPT)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:J
Last Name:BIRT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7575 W WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-4333
Mailing Address - Country:US
Mailing Address - Phone:702-380-1515
Mailing Address - Fax:702-380-1511
Practice Address - Street 1:7660 W CHEYENNE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-6757
Practice Address - Country:US
Practice Address - Phone:702-880-1515
Practice Address - Fax:702-880-1511
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2019225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist