Healthcare Provider Details

I. General information

NPI: 1669599239
Provider Name (Legal Business Name): KIRK J. SACHTLER DPT, OCS, CMPT, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 02/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 ROBB DR SUITE 103
RENO NV
89523-2524
US

IV. Provider business mailing address

720 ROBB DR SUITE 103
RENO NV
89523-2524
US

V. Phone/Fax

Practice location:
  • Phone: 775-787-3733
  • Fax: 775-787-3744
Mailing address:
  • Phone: 775-787-3733
  • Fax: 775-787-3744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number496
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: