Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 2283 | NV |
N | 225100000X | Physical Therapist | PT-1961 | ID |
N | 2251S0007X | Physical Therapist - Sports | 9653 | WA |
NPI | 1386674265 |
---|---|
Provider Name | Dana Krank |
First Address | Las Vegas, NV 89119-5164 |
Second Address | Las Vegas, NV 89119-5164 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 22/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000010150922 | BLUE SHIELD (01) | ID |
0198311 | LABOR AND INDUSTRY (01) | WA |
1386674265 | (05) | NV |
1386674265 | NPI (01) | NV |
TC928 | BLUE CROSS (01) | ID |