Basic Information
| Provider Information | |||||||||
| NPI: | 1306802533 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEVADA PHYSICAL THERAPY INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8440 | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895078940 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757841999 | ||||||||
| FaxNumber: | 7757841995 | ||||||||
| Practice Location | |||||||||
| Address1: | UNR SPROTS MEDICINE COMPLEX | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757841999 | ||||||||
| FaxNumber: | 7757841995 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2006 | ||||||||
| LastUpdateDate: | 11/28/2007 | ||||||||
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| AuthorizedOfficialLastName: | CUDWORTH | ||||||||
| AuthorizedOfficialFirstName: | EUGEN | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7757841999 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | RPT | ||||||||
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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 |
No ID Information.