Individual
DERRICK RYAN ANTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
7189 ADVANCED WAY, LAS VEGAS, NV 89113-3691
(702) 777-7050
(702) 777-7051
Mailing address
7195 ADVANCED WAY, LAS VEGAS, NV 89113-3691
(702) 740-5327
(702) 740-5328
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4085
NV
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250005707
—
NV
Enumeration date
10/03/2019
Last updated
03/16/2022
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