Provider Demographics
NPI:1942609466
Name:BOTSFORD, BETSY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:
Last Name:BOTSFORD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 W HORIZON RIDGE PKWY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2896
Mailing Address - Country:US
Mailing Address - Phone:702-896-0383
Mailing Address - Fax:702-889-0383
Practice Address - Street 1:2625 W HORIZON RIDGE PKWY
Practice Address - Street 2:SUITE 120
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2896
Practice Address - Country:US
Practice Address - Phone:702-896-0383
Practice Address - Fax:702-889-0383
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist