Individual provider · NPI-1

Corey Deven Ackley, PT, DPT

Physical Therapist · Las Vegas, NV

NPI number1124686027
StatusActive
Last updated in NPPESJun 5, 2019

Details

NPI
1124686027
Entity type
Individual (NPI-1)
Name
Corey Deven Ackley
Credential
PT, DPT
Sex
Male
Sole proprietor
No
Enumeration date
Jun 5, 2019
Last updated
Jun 5, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist4026NVYes

Practice location

2650 N Tenaya Way Ste 180
Las Vegas, NV 89128-1110

Phone 702-240-2952

Mailing address

10531 Brownsville Ave
Las Vegas, NV 89129-3217

Phone 702-239-5016

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