Provider Demographics
NPI:1821406430
Name:ATHLETES PHYSIOTHERAPY LLC
Entity Type:Organization
Organization Name:ATHLETES PHYSIOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSCH
Authorized Official - Suffix:
Authorized Official - Credentials:PT DPT ATC
Authorized Official - Phone:702-768-9996
Mailing Address - Street 1:900 W WARM SPRINGS RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-4276
Mailing Address - Country:US
Mailing Address - Phone:702-768-9996
Mailing Address - Fax:
Practice Address - Street 1:900 W WARM SPRINGS RD
Practice Address - Street 2:SUITE 103
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89011-4276
Practice Address - Country:US
Practice Address - Phone:702-768-9996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20141334042261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy