Organization
MIMCR
Active
Organization
MIMCR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW THOMAS (PRESIDENT)
(702) 235-5191
Entity
Organization
Contact information
Practice address
800 N RAINBOW BLVD STE 208, LAS VEGAS, NV 89107-1193
(702) 235-5191
(702) 472-8730
Mailing address
800 N RAINBOW BLVD STE 208, LAS VEGAS, NV 89107-1193
(702) 235-5191
(702) 472-8730
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1594
NV
Other
Enumeration date
12/31/2013
Last updated
12/31/2013
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