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NPI Code Detail

MEDICARE: JIMMY NGUYEN DPT

MEDICARE: JIMMY NGUYEN 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 Therapist3012NV

General Provider Information

NPI Number : 1902295454
Entity Type Code : Individual
Provider Name (Legal Business Name) : JIMMY NGUYEN DPT
Provider Business Mailing Address
First Line : 5538 DUNCAN DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-2812
Country : US
Telephone Number : 702-645-2606
Fax Number :
Provider Business Practice Location Address
First Line : 5538 DUNCAN DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-2812
Country : US
Telephone Number : 702-645-2606
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2015
Last Update Date : 01/21/2015

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