Healthcare Provider Details

I. General information

NPI: 1639031651
Provider Name (Legal Business Name): BREATHE MYO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2025
Last Update Date: 11/28/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4790 CAUGHLIN PKWY. STE. 357
RENO NV
89519
US

IV. Provider business mailing address

4790 CAUGHLIN PKWY. STE. 357
RENO NV
89519
US

V. Phone/Fax

Practice location:
  • Phone: 775-453-6833
  • Fax:
Mailing address:
  • Phone: 775-453-6833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. XUAN-THU THI LOVELL
Title or Position: OWNER
Credential: ROH, OMT
Phone: 775-544-5751