Provider Demographics
NPI:1447582325
Name:FLISSER, LAWRENCE E (PT, MSPT)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:E
Last Name:FLISSER
Suffix:
Gender:M
Credentials:PT, MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9550 S EASTERN AVE STE 253
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-8042
Mailing Address - Country:US
Mailing Address - Phone:702-818-1770
Mailing Address - Fax:702-964-1335
Practice Address - Street 1:1386 S BOULDER HWY STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-7091
Practice Address - Country:US
Practice Address - Phone:702-818-1717
Practice Address - Fax:702-922-3637
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3031225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1659727964OtherPHYSICAL THERAPY