Organization
MAXICARE THERAPY AND WELLNESS OF NEVADA
Active
Organization
MAXICARE THERAPY AND WELLNESS OF NEVADA
Active
Other names
Maxicare Therapy and Wellness of Nevada
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE GORGONIA TIU JR. DPT (PHYSICAL THERAPIST)
(702) 381-6053
Entity
Organization
Contact information
Practice address
4510 S EASTERN AVE STE 5, LAS VEGAS, NV 89119-6118
(702) 381-6053
(702) 987-0199
Mailing address
4510 S EASTERN AVE STE 5, LAS VEGAS, NV 89119-6118
(702) 381-6053
(702) 987-0199
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251C2600X
Cardiopulmonary Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
2278P1005X
Pulmonary Rehabilitation Certified Respiratory Therapist
—
—
Other
Enumeration date
02/04/2020
Last updated
01/19/2022
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