MEDICARE: ZACHARY VINCENT NYMAN 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	6503	NV

General Provider Information

NPI Number	:	1285465229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY VINCENT NYMAN DPT

Provider Business Mailing Address
First Line	:	6040 S RAINBOW BLVD STE B1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2542
Country	:	US
Telephone Number	:	702-876-9737
Fax Number	:	702-876-9741

Provider Business Practice Location Address
First Line	:	6040 S RAINBOW BLVD STE B1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2542
Country	:	US
Telephone Number	:	702-876-9737
Fax Number	:	702-876-9741

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

Provider Enumeration Date	:	08/12/2024
Last Update Date	:	01/28/2025

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