Provider Demographics
NPI:1871863068
Name:GEX, SUSAN (PT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:GEX
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7301 PEAK DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-9037
Mailing Address - Country:US
Mailing Address - Phone:702-256-9738
Mailing Address - Fax:702-242-5629
Practice Address - Street 1:4000 S EASTERN AVE
Practice Address - Street 2:#300
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-0824
Practice Address - Country:US
Practice Address - Phone:702-734-2732
Practice Address - Fax:702-737-1453
Is Sole Proprietor?:No
Enumeration Date:2012-01-05
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV2509225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist