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NPI Code Detail

MEDICARE: MR. RYAN MASUDA PT, DPT

MEDICARE: MR. RYAN MASUDA 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 Therapist3844NV

General Provider Information

NPI Number : 1740764778
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RYAN MASUDA PT, DPT
Provider Business Mailing Address
First Line : 2606 S DURANGO DR APT 175
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-2653
Country : US
Telephone Number : 714-308-3763
Fax Number :
Provider Business Practice Location Address
First Line : 3870 W ANN RD STE 110
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-4412
Country : US
Telephone Number : 702-396-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2018
Last Update Date : 09/14/2018

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Directions to “ MR. RYAN MASUDA PT, DPT” Practice Location

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