Provider Demographics
NPI:1376747238
Name:O'NEILL, KARMIN KATHLEEN (DPT, MTC)
Entity type:Individual
Prefix:MRS
First Name:KARMIN
Middle Name:KATHLEEN
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:DPT, MTC
Other - Prefix:MRS
Other - First Name:KARMIN
Other - Middle Name:KATHLEEN
Other - Last Name:VIDANA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT, MTC
Mailing Address - Street 1:8153 WHITE MILL CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-1457
Mailing Address - Country:US
Mailing Address - Phone:702-878-7678
Mailing Address - Fax:
Practice Address - Street 1:3100 N TENAYA WAY
Practice Address - Street 2:SUITE 130
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0436
Practice Address - Country:US
Practice Address - Phone:702-255-5018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1632225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist