Organization
WILDCREEK PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLYN MARIE JUNTA P.T. (CEO)
(775) 673-9700
Entity
Organization
Contact information
Practice address
2255 GREEN VISTA DR, STE. 401, SPARKS, NV 89431-8534
(775) 673-9700
(775) 673-9799
Mailing address
2255 GREEN VISTA DR, STE. 401, SPARKS, NV 89431-8534
(775) 673-9700
(775) 673-9799
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
NV213
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003416002
—
NV
01
—
7634
BCBS
NV
01
—
RPT213
MEDICARE
NV
Enumeration date
04/17/2008
Last updated
05/14/2008
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