Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | 3133 | NV |
Y | 2251X0800X | Physical Therapist - Orthopedic | 3133 | NV |
NPI | 1003297409 |
---|---|
Provider Name | Dr. Erin Longhurst |
First Address | Henderson, NV 89012-3249 |
Second Address | Las Vegas, NV 89128-1102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2015 |
Last Update Date | 11/06/2015 |