Provider Demographics
NPI:1013526045
Name:DIRECT TO YOU PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:DIRECT TO YOU PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GROH
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MS, SCS, ATC
Authorized Official - Phone:702-308-1277
Mailing Address - Street 1:10334 HOWLING COYOTE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-1119
Mailing Address - Country:US
Mailing Address - Phone:702-308-1277
Mailing Address - Fax:
Practice Address - Street 1:10334 HOWLING COYOTE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-1119
Practice Address - Country:US
Practice Address - Phone:702-308-1277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy