Provider Demographics
NPI:1063849412
Name:MASGA, VICKI ROSE
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:ROSE
Last Name:MASGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 AMBUSH DR.
Mailing Address - Street 2:UNIT 1
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048
Mailing Address - Country:US
Mailing Address - Phone:775-727-0341
Mailing Address - Fax:
Practice Address - Street 1:1800 AMBUSH DR
Practice Address - Street 2:UNIT 1
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048
Practice Address - Country:US
Practice Address - Phone:775-727-0341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner