Individual
LYLE DANIEL DSOUZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
20 WEST ST, FERNLEY, NV 89408-9799
(775) 575-5508
Mailing address
20 WEST ST, FERNLEY, NV 89408-9799
(775) 575-5508
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3720
NV
2251G0304X
Geriatric Physical Therapist
3720
NV
Other
Enumeration date
12/26/2019
Last updated
12/26/2019
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