Provider Demographics
NPI:1740231224
Name:TRU PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:TRU PHYSICAL THERAPY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:702-856-0422
Mailing Address - Street 1:70 E HORIZON RIDGE PKWY
Mailing Address - Street 2:#180
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-7935
Mailing Address - Country:US
Mailing Address - Phone:702-856-0422
Mailing Address - Fax:702-433-0425
Practice Address - Street 1:70 E HORIZON RIDGE PKWY
Practice Address - Street 2:#180
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-7935
Practice Address - Country:US
Practice Address - Phone:702-856-0422
Practice Address - Fax:702-433-0425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV134706225100000X
261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV100884Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER