Organization · NPI-2

Full Function Physical Therapy, LLC

Physical Therapist · Henderson, NV

NPI number1043955099

StatusActive

Last updated in NPPESAug 12, 2022

Details

NPI: 1043955099
Entity type: Organization (NPI-2)
Legal business name: Full Function Physical Therapy, LLC
Organization subpart: No
Enumeration date: May 4, 2022
Certification date: Aug 12, 2022
Last updated: Aug 12, 2022

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
225100000X	Physical Therapist	–	–	Yes
163WM1400X	Registered Nurse, Nurse Massage Therapist (NMT)	–	–
225200000X	Physical Therapy Assistant	–	–
225700000X	Massage Therapist	–	–

Practice location

2250 Corporate Cir Ste 350
Henderson, NV 89074-7714

Phone 702-522-7858 · Fax 702-522-7897

Mailing address

124 Soaring Sky Ave
Henderson, NV 89011-2535

Authorized official

Sandy Friday
Credentialer
7028008988

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