Basic Information
| Provider Information | |||||||||
| NPI: | 1104927342 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KUHN PHYSICAL THERAPY LLC | ||||||||
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| OtherOrganizationName: | PREMIER PHYSICAL THERAPY & SPORTS PERFORMANCE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 615 SIERRA ROSE DR | ||||||||
| Address2: | SUITE 2A | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895112060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758289724 | ||||||||
| FaxNumber: | 7758289728 | ||||||||
| Practice Location | |||||||||
| Address1: | 615 SIERRA ROSE DR | ||||||||
| Address2: | SUITE 2A | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895112060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758289724 | ||||||||
| FaxNumber: | 7758289728 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2006 | ||||||||
| LastUpdateDate: | 06/04/2014 | ||||||||
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| AuthorizedOfficialLastName: | GREENGARD | ||||||||
| AuthorizedOfficialFirstName: | ALAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGING MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 7758289724 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 100503614 | 05 | NV | MEDICAID |