Healthcare Provider Details

I. General information

NPI: 1023058054
Provider Name (Legal Business Name): JOAN JARBOE BUCKLER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOAN ELLEN JARBOE PT

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 LOCUST ST PHYSICAL THERAPY DEPT
RENO NV
89502-2597
US

IV. Provider business mailing address

1771 CANYON SHADOW CIR
RENO NV
89521-5011
US

V. Phone/Fax

Practice location:
  • Phone: 775-786-7200
  • Fax: 775-337-2260
Mailing address:
  • Phone: 775-232-9691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number1891
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: