Provider Demographics
NPI:1972168540
Name:THERAPY WEST LLC
Entity type:Organization
Organization Name:THERAPY WEST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER/OM
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:T
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-660-2694
Mailing Address - Street 1:9050 W CHEYENNE AVE # 210
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-8932
Mailing Address - Country:US
Mailing Address - Phone:702-209-0069
Mailing Address - Fax:702-750-1372
Practice Address - Street 1:9050 W CHEYENNE AVE # 210
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-8932
Practice Address - Country:US
Practice Address - Phone:702-209-0069
Practice Address - Fax:702-750-1372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty