1740231224 NPI number — TRU PHYSICAL THERAPY INC

Table of content: (NPI 1740231224)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740231224 NPI number — TRU PHYSICAL THERAPY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRU PHYSICAL THERAPY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TRU PHYSICAL THERAPY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740231224
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/20/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
70 E HORIZON RIDGE PKWY
Provider Second Line Business Mailing Address:
#180
Provider Business Mailing Address City Name:
HENDERSON
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89015-7935
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-856-0422
Provider Business Mailing Address Fax Number:
702-433-0425

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
70 E HORIZON RIDGE PKWY
Provider Second Line Business Practice Location Address:
#180
Provider Business Practice Location Address City Name:
HENDERSON
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89015-7935
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-856-0422
Provider Business Practice Location Address Fax Number:
702-433-0425
Provider Enumeration Date:
05/12/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
EVANS
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
PAUL
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
702-856-0422

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  134706 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)