Organization
GOLD STAR PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAYNELLA MARIE TIU PT (OWNER)
(314) 629-2150
Entity
Organization
Contact information
Practice address
2651 CRIMSON CANYON DR STE 120, LAS VEGAS, NV 89128-0843
(314) 629-2150
Mailing address
2651 CRIMSON CANYON DR STE 120, LAS VEGAS, NV 89128-0843
Taxonomy
Speciality
Code
Description
License number
State
2251C2600X
Cardiopulmonary Physical Therapist
Primary
—
—
Other
Enumeration date
12/21/2020
Last updated
01/19/2021
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