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Organization
NEW LIGHT THERAPY
Active
Organization
NEW LIGHT THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN VAILLANCOURT D.P.T. (PHYSICAL THERAPIST)
(775) 235-8809
Entity
Organization
Contact information
Practice address
2869 ESAW ST, MINDEN, NV 89423-9059
(775) 235-8809
(775) 420-4675
Mailing address
1329 HWY 395, SUITE 10-274, GARDNERVILLE, NV 89410
(775) 235-8809
(775) 420-4675
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
320700000X
Physical Disabilities Residential Treatment Facility
Primary
NV20101224552
NV
Other
Enumeration date
05/28/2011
Last updated
06/18/2024
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