Individual
TAVIN GLENN FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
129 W LAKE MEAD PKWY STE 2, HENDERSON, NV 89015-7055
(702) 564-6712
Mailing address
685 LUCKY PINE ST, HENDERSON, NV 89002-3300
(702) 575-1230
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4544
NV
Other
Enumeration date
05/26/2021
Last updated
05/26/2021
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