Organization
ADVANCED MANUEL THERAPY INSTITUTE 1 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHEL S RANTISSI JR. DPT, MOT, MTC (OWNER)
(702) 896-0383
Entity
Organization
Contact information
Practice address
911 N BUFFALO DR, #107, LAS VEGAS, NV 89128-0379
(702) 896-0383
(702) 889-0383
Mailing address
2625 W HORIZON RIDGE PKWY, #120, HENDERSON, NV 89052-2896
(702) 896-0383
(702) 889-0383
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1719
NV
225100000X
Physical Therapist
Primary
1735
NV
225X00000X
Occupational Therapist
0662
NV
225X00000X
Occupational Therapist
0663
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
V101389
PTAN
NV
01
—
V101390
PTAN
NV
01
—
V101391
PTAN
NV
01
—
V101392
PTAN
NV
01
—
V101393
PTAN
NV
Enumeration date
07/25/2007
Last updated
06/17/2013
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