Provider Demographics
NPI:1013796234
Name:GORAL, KERRY LEE JR (DPT)
Entity Type:Individual
Prefix:DR
First Name:KERRY
Middle Name:LEE
Last Name:GORAL
Suffix:JR
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:915 ALPER CENTER DR UNIT 28305
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-1554
Mailing Address - Country:US
Mailing Address - Phone:714-244-8181
Mailing Address - Fax:
Practice Address - Street 1:2651 PASEO VERDE PKWY STE 170
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-6616
Practice Address - Country:US
Practice Address - Phone:702-312-4878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV6265225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist