Provider Demographics
NPI:1245451467
Name:WINDOUS, VINCENT K (MPT)
Entity type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:K
Last Name:WINDOUS
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 151006
Mailing Address - Street 2:
Mailing Address - City:ELY
Mailing Address - State:NV
Mailing Address - Zip Code:89315-1006
Mailing Address - Country:US
Mailing Address - Phone:775-289-4588
Mailing Address - Fax:
Practice Address - Street 1:1500 AVENUE H
Practice Address - Street 2:
Practice Address - City:ELY
Practice Address - State:NV
Practice Address - Zip Code:89301-2615
Practice Address - Country:US
Practice Address - Phone:775-289-3467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1372225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist