Provider Demographics
NPI:1336266717
Name:YOSHIDA, GARRETT JAMES (PT)
Entity Type:Individual
Prefix:MR
First Name:GARRETT
Middle Name:JAMES
Last Name:YOSHIDA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10784 AVENZANO ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-3503
Mailing Address - Country:US
Mailing Address - Phone:702-419-3638
Mailing Address - Fax:
Practice Address - Street 1:505 E CAPOVILLA AVE STE 104
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-4332
Practice Address - Country:US
Practice Address - Phone:702-896-6393
Practice Address - Fax:702-739-0105
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14992251G0304X, 2251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Not Answered2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology