Healthcare Provider Details

I. General information

NPI: 1508041690
Provider Name (Legal Business Name): CHRISTINE M STITSER M.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10587 DOUBLE R BLVD
RENO NV
89521-5868
US

IV. Provider business mailing address

10587 DOUBLE R BLVD
RENO NV
89521-5868
US

V. Phone/Fax

Practice location:
  • Phone: 775-324-5371
  • Fax:
Mailing address:
  • Phone: 775-324-5371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1518
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number1518
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: