Individual
ISAIAH IAEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2035 W CHARLESTON BLVD, LAS VEGAS, NV 89102-2223
(808) 428-4184
Mailing address
PO BOX 711185, SALT LAKE CITY, UT 84171-1185
(801) 942-3311
(801) 942-5955
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3701
NV
225100000X
Physical Therapist
—
—
Other
Enumeration date
04/24/2015
Last updated
12/03/2019
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