Basic Information
| Provider Information | |||||||||
| NPI: | 1780053694 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | TRAN | ||||||||
| FirstName: | TONY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 850 ARROWCREEK PKWY UNIT 21404 | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895115482 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5042508496 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1573 MULLER PKWY | ||||||||
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| City: | GARDNERVILLE | ||||||||
| State: | NV | ||||||||
| PostalCode: | 894107918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757826620 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2015 | ||||||||
| LastUpdateDate: | 02/28/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT 60572414 | WA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 3926 | NV | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.