Organization
FAMILY AND SPORTS PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF DIETRICH PT (DIRECTOR, SECRETARY)
(702) 968-0520
Entity
Organization
Contact information
Practice address
7351 PRAIRIE FALCON RD STE 100, LAS VEGAS, NV 89128-0820
(702) 968-0520
(702) 968-0521
Mailing address
7351 PRAIRIE FALCON RD STE 100, LAS VEGAS, NV 89128-0820
(702) 968-0520
(702) 968-0521
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/26/2006
Last updated
04/21/2015
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