Provider Demographics
NPI:1548885684
Name:HILL, STEPHEN BURKE (PT, DPT)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:BURKE
Last Name:HILL
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9975 PEACE WAY UNIT 1169
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8439
Mailing Address - Country:US
Mailing Address - Phone:801-921-0391
Mailing Address - Fax:
Practice Address - Street 1:3530 E FLAMINGO RD STE 115
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5091
Practice Address - Country:US
Practice Address - Phone:702-954-4020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4311225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty