Individual
SAMANTHA RYCKEBOSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
425 CAMINO DE GRATO, SPARKS, NV 89441-7536
(775) 848-4302
Mailing address
425 CAMINO DE GRATO, SPARKS, NV 89441-7536
(775) 848-4302
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14
—
NV
Enumeration date
07/02/2015
Last updated
07/02/2015
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