Matthew Richard Wisehart, DPT | |
3155 W Craig Rd Ste 120140, North Las Vegas, NV 89032-0782 | |
(702) 639-2333 | |
(702) 639-2334 |
Full Name | Matthew Richard Wisehart |
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Gender | Male |
Speciality | Physical Therapist |
Location | 3155 W Craig Rd Ste 120140, North Las Vegas, Nevada |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063861060 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 12255 (Arizona) | Secondary |
225100000X | Physical Therapist | PT-6532 (Idaho) | Primary |
Provider Name | Ati Holdings Of Arizona Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1871570309 PECOS PAC ID: 2466732862 Enrollment ID: O20161130001683 |
Mailing Address | Practice Location Address |
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Matthew Richard Wisehart, DPT 790 Remington Blvd, Bolingbrook, IL 60440-4909 Ph: () - | Matthew Richard Wisehart, DPT 3155 W Craig Rd Ste 120140, North Las Vegas, NV 89032-0782 Ph: (702) 639-2333 |
Advanced Manual Therapy Institute I Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6424 Losee Rd, Suite 120, North Las Vegas, NV 89086 Phone: 702-896-0383 Fax: 702-889-0383 | |
Mark Tee, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3215 E Cheyenne Ave, North Las Vegas, NV 89030 Phone: 702-858-4538 | |
Jon Moot, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2225 E Centennial Pkwy Ste 106, North Las Vegas, NV 89081 Phone: 702-936-7165 | |
Denis Milian Shostak, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1550 W Craig Rd Ste 210, North Las Vegas, NV 89032 Phone: 702-360-9142 | |
Brady Powell, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2225 Civic Center Dr Ste 100, North Las Vegas, NV 89030 Phone: 702-586-5778 Fax: 702-586-5758 | |
Tyler J Calvert, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4080 North Martin Luther King Blvd, Suite 101a, North Las Vegas, NV 89032 Phone: 702-360-9142 |