Organization
SPIRIT MOBILE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE SIDECO (MANAGER)
(702) 326-0528
Entity
Organization
Contact information
Practice address
8695 S EASTERN AVE, LAS VEGAS, NV 89123-2839
(702) 326-0528
(702) 796-6310
Mailing address
7575 W WASHINGTON AVE STE 127-140, LAS VEGAS, NV 89128-4333
(702) 326-0528
(702) 796-6310
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
01/09/2020
Last updated
04/20/2021
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