Provider Demographics
NPI:1912664871
Name:PREMIER PHYSICAL THERAPY AND PULMONARY REHAB LLC
Entity Type:Organization
Organization Name:PREMIER PHYSICAL THERAPY AND PULMONARY REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMA
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:702-334-6852
Mailing Address - Street 1:1771 E FLAMINGO RD STE 100A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5156
Mailing Address - Country:US
Mailing Address - Phone:702-800-6887
Mailing Address - Fax:702-800-6248
Practice Address - Street 1:1771 E FLAMINGO RD STE 100A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5156
Practice Address - Country:US
Practice Address - Phone:702-800-6887
Practice Address - Fax:702-800-6248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-25
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGroup - Multi-Specialty