Doctor Name: | ELIZABETH MANGER FRAGOSO |
NPI Number: | 1629203575 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 1371 |
Business Practice Address: | 4640 W Craig Rd N Las Vegas, NV - 890322743 |
Business Phone Number: | 7028390091 |
Business Fax Number: | 7028390095 |
Mailing Address: | 2870 S Maryland Pkwy., Suite 230 LAS VEGAS |
State: | NV |
Postal Code: | 891091548 |
Phone Number: | 7028933333 |
Fax Number: | 7028930960 |
NPI Enumeration Date: | 05/21/2009 |
NPI Last Update Date: | 04/01/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 1371 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NV |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |