Provider Demographics
NPI:1851557771
Name:PDS THERAPY INC
Entity Type:Organization
Organization Name:PDS THERAPY INC
Other - Org Name:THERAPY ON WHEELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:PAIGE
Authorized Official - Last Name:OLIVADOTI-SANTORO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:702-448-4200
Mailing Address - Street 1:7065 W ANN RD
Mailing Address - Street 2:130-407
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-3865
Mailing Address - Country:US
Mailing Address - Phone:702-448-4200
Mailing Address - Fax:702-448-4200
Practice Address - Street 1:7065 W ANN RD
Practice Address - Street 2:130-407
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3865
Practice Address - Country:US
Practice Address - Phone:702-448-4200
Practice Address - Fax:702-448-4200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV00320011Medicaid