Healthcare Provider Details

I. General information

NPI: 1861442501
Provider Name (Legal Business Name): HIGH DESERT THERAPISTS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 12/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 PINE CONE RD
DAYTON NV
89403-7393
US

IV. Provider business mailing address

2874 N CARSON ST SUITE 100
CARSON CITY NV
89706-0177
US

V. Phone/Fax

Practice location:
  • Phone: 775-246-7742
  • Fax:
Mailing address:
  • Phone: 775-883-4161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNV

VIII. Authorized Official

Name: LENDELL RICHARD STEPHENSON
Title or Position: PT/PRESIDENT
Credential: RPT
Phone: 775-883-4161