Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 1592 | NV |
NPI | 1033378443 |
---|---|
Provider Name | Lewis Scott Langdale |
First Address | Las Vegas, NV 89109-1502 |
Second Address | Las Vegas, NV 89109-1502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2008 |
Last Update Date | 02/06/2008 |