Provider Demographics
NPI:1518402874
Name:ZUBIZARRETA, JOSU ANTXON
Entity Type:Individual
Prefix:
First Name:JOSU
Middle Name:ANTXON
Last Name:ZUBIZARRETA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 E PRATER WAY
Mailing Address - Street 2:STE 103
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-8972
Mailing Address - Country:US
Mailing Address - Phone:775-331-1199
Mailing Address - Fax:775-331-1180
Practice Address - Street 1:1450 E PRATER WAY
Practice Address - Street 2:STE 103
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-8972
Practice Address - Country:US
Practice Address - Phone:775-331-1199
Practice Address - Fax:775-331-1180
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-22
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3462225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist