Organization
BENGOA PHYSICAL THERAPY LLC
Active
Organization
BENGOA PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BENGOA PT, MS (PT/MANAGING MEMBER)
(775) 455-0049
Entity
Organization
Contact information
Practice address
100 CARSON RD STE B, BATTLE MOUNTAIN, NV 89820-2311
(775) 455-0049
(775) 539-3234
Mailing address
100 CARSON RD STE B, BATTLE MOUNTAIN, NV 89820-2311
(775) 455-0049
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A-1790
PHYSICAL THERAPY ASSISTANT
NV
Enumeration date
07/16/2024
Last updated
08/06/2025
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