Provider Demographics
NPI:1174773618
Name:IZATT, CHARLOTTE JANENE (PT)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:JANENE
Last Name:IZATT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JANENE
Other - Middle Name:
Other - Last Name:IZATT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, MPT
Mailing Address - Street 1:3041 W HORIZON RIDGE PKWY STE 140
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4445
Mailing Address - Country:US
Mailing Address - Phone:702-565-6565
Mailing Address - Fax:702-565-8898
Practice Address - Street 1:3041 W HORIZON RIDGE PKWY STE 140
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4445
Practice Address - Country:US
Practice Address - Phone:702-565-6565
Practice Address - Fax:702-565-8898
Is Sole Proprietor?:No
Enumeration Date:2008-09-21
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0866225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist