Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | A-0720 | NV |
NPI | 1013430917 |
---|---|
Provider Name | Stephanie Newbury |
First Address | Las Vegas, NV 89149-1321 |
Second Address | Las Vegas, NV 89149-0210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2017 |
Last Update Date | 23/07/2017 |