Organization
KIDS THERAPY LV CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JADE MADISON (PRESIDENT)
(702) 499-0443
Entity
Organization
Contact information
Practice address
1657 E DESERT INN RD, LAS VEGAS, NV 89169-2514
(702) 534-0094
(702) 726-9527
Mailing address
1657 E DESERT INN RD, LAS VEGAS, NV 89169-2514
(702) 534-0094
(702) 726-9527
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
10-0057
NV
225XP0019X
Physical Rehabilitation Occupational Therapist
10-0057
NV
225XP0200X
Pediatric Occupational Therapist
Primary
10-0057
NV
Other
Enumeration date
11/28/2011
Last updated
09/18/2014
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