Most Relevant Information
Provider Data
| NPI Number: | 1003004342 |
| Provider Name: | SHINGO TANAKA MPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PT011869 |
Most Important Dates
| Enumeration Date: | 10/11/2007 |
| Last Updated: | 10/10/2013 |
Provider Practice Location
225 EAGLE CREST ST
RANGELY
CO
816483105
Practice Location Phone/Fax
| Phone: | 9706754205 |
| Fax: | 9706754270 |
Provider Mailing Location
225 EAGLE CREST ST
RANGELY
CO
816483105
Provider Mailing Phone/Fax
| Phone: | 9706754205 |
| Fax: | 9706754270 |