Provider Demographics
NPI:1134147697
Name:TURNER, MARK A (MPT)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:A
Last Name:TURNER
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:MR
Other - First Name:MARK
Other - Middle Name:A
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPT
Mailing Address - Street 1:11201 S EASTERN AVE
Mailing Address - Street 2:STE 220
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-6201
Mailing Address - Country:US
Mailing Address - Phone:702-614-0324
Mailing Address - Fax:702-341-0324
Practice Address - Street 1:7455 W WASHINGTON AVE
Practice Address - Street 2:STE 215
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-4337
Practice Address - Country:US
Practice Address - Phone:702-307-0938
Practice Address - Fax:702-307-0946
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1646225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV38256Medicare ID - Type Unspecified