Individual
RICKY SHIGERU MIYASHIRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS PT
Contact information
Practice address
1107 HWY 395 S, GARDNERVILLE, NV 89410
(775) 782-1517
(775) 782-1552
Mailing address
1107 HWY 395 S, GARDNERVILLE, NV 89410
(775) 782-1517
(775) 782-1552
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
900
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16809
LICENSE
CA
01
—
900
LICENSE
NV
Enumeration date
04/27/2007
Last updated
07/08/2007
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