Healthcare Provider Details

I. General information

NPI: 1336217009
Provider Name (Legal Business Name): PARLEY ISAAC ANDERSON DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3594 W PLUMB LN SUITE B
RENO NV
89509-3696
US

IV. Provider business mailing address

3594 W PLUMB LN SUITE B
RENO NV
89509-3696
US

V. Phone/Fax

Practice location:
  • Phone: 775-786-2400
  • Fax: 775-786-2411
Mailing address:
  • Phone: 775-786-2400
  • Fax: 775-786-2411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number1759
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: