Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 2006002067 | MO |
N | 225100000X | Physical Therapist | 2276 | NV |
Y | 2251C2600X | Cardiopulmonary | 2276 | NV |
NPI | 1720248008 |
---|---|
Provider Name | Miss Faynella S Tiu |
First Address | Las Vegas, NV 89128-0843 |
Second Address | Las Vegas, NV 89128-0843 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2008 |
Last Update Date | 18/06/2021 |