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NPI Code Detail

MEDICARE: MR. SKYLAR LANE TARBET PT, DPT

MEDICARE:  MR. SKYLAR LANE TARBET  PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT 60717697WA
2225100000XPhysical Therapist3316NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033567466
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SKYLAR LANE TARBET PT, DPT
Provider Business Mailing Address
First Line : 250 COUNTRY CLUB PKWY
Second Line :
City : SPRING CREEK
State : NV
Zip : 89815-5830
Country : US
Telephone Number : 775-777-1276
Fax Number : 775-777-7022
Provider Business Practice Location Address
First Line : 250 COUNTRY CLUB PKWY
Second Line :
City : SPRING CREEK
State : NV
Zip : 89815-5830
Country : US
Telephone Number : 775-777-1276
Fax Number : 775-777-7022
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2016
Last Update Date : 01/23/2020

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