Basic Information
| Provider Information | |||||||||
| NPI: | 1124025523 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOUIE | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1680 W WILLIAMS AVE | ||||||||
| Address2: | |||||||||
| City: | FALLON | ||||||||
| State: | NV | ||||||||
| PostalCode: | 894062644 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1775867390 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1680 W WILLIAMS AVE | ||||||||
| Address2: | |||||||||
| City: | FALLON | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758673904 | ||||||||
| FaxNumber: | 7758673901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2005 | ||||||||
| LastUpdateDate: | 10/08/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1611 | NV | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.