Healthcare Provider Details

I. General information

NPI: 1336191832
Provider Name (Legal Business Name): JESSIE DAY THOMAS MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

679 SIERRA ROSE DR SUITE A
RENO NV
89511-2060
US

IV. Provider business mailing address

2789 MONTEGO DR
RENO NV
89523
US

V. Phone/Fax

Practice location:
  • Phone: 775-324-4800
  • Fax:
Mailing address:
  • Phone: 775-746-0210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number1441
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: