Individual
BEAU HAVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
2904 W HORIZON RIDGE PKWY STE 121, HENDERSON, NV 89052-5016
(702) 897-7331
Mailing address
379 LANDER DR, HENDERSON, NV 89074-1308
(702) 701-3140
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3822
NV
Other
Enumeration date
08/13/2018
Last updated
12/19/2023
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