MEDICARE: VANESSA MILRAD 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
1	225100000X	Physical Therapist	38533	CA
2	225100000X	Physical Therapist	4166	NV

General Provider Information

NPI Number	:	1992000699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA MILRAD DPT

Provider Business Mailing Address
First Line	:	2650 N TENAYA WAY STE 180
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1110
Country	:	US
Telephone Number	:	702-240-2952
Fax Number	:	702-243-0482

Provider Business Practice Location Address
First Line	:	2650 N TENAYA WAY STE 180
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1110
Country	:	US
Telephone Number	:	702-240-2952
Fax Number	:	702-243-0482

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2011
Last Update Date	:	01/15/2020

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Directions to “ VANESSA MILRAD DPT” Practice Location

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