Provider Demographics
NPI:1649647652
Name:CARLSTON, ALEXIS NICHOLE (DPT)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:NICHOLE
Last Name:CARLSTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:KALDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2017 SILVERTON DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-1552
Mailing Address - Country:US
Mailing Address - Phone:516-205-3899
Mailing Address - Fax:
Practice Address - Street 1:9005 S PECOS RD STE 2520
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7191
Practice Address - Country:US
Practice Address - Phone:702-818-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-25
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3147225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist