Organization
ELEVATION PHYSICAL THERAPY AND SPORTS AND REHABILITATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL DUDLEY RUSSELL DPT (MANAGER)
(702) 768-8050
Entity
Organization
Contact information
Practice address
10245 S MARYLAND PKWY 153, LAS VEGAS, NV 89183
(702) 768-8050
(702) 731-2565
Mailing address
10245 S MARYLAND PKWY UNIT 153, LAS VEGAS, NV 89183-4041
(702) 768-8050
(702) 731-2565
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1007638532
NV
Other
Enumeration date
08/22/2008
Last updated
08/22/2008
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