Organization
SPORTS LLC
Active
Organization
SPORTS LLC
Active
Other names
FYZICAL SPORTS
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE HOLMSTROM (ADMINISTRATOR)
(702) 655-8535
Entity
Organization
Contact information
Practice address
7770 DEAN MARTIN DR STE 307, LAS VEGAS, NV 89139
(702) 445-7554
Mailing address
9070 W CHEYENNE AVE STE 100, LAS VEGAS, NV 89129
(702) 655-8535
(702) 656-5863
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NV
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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