Individual
MYRA JUNE S VESAGAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4275 BURNHAM AVE., SUITE 255, LAS VEGAS, NV 89119-8204
(702) 380-1060
Mailing address
P.O. BOX 26299, LAS VEGAS, NV 89126-0299
(702) 893-3333
(702) 893-0960
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2073
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001702161
—
NV
05
—
1053594937
—
NV
Enumeration date
06/06/2008
Last updated
07/10/2012
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