Healthcare Provider Details

I. General information

NPI: 1841567344
Provider Name (Legal Business Name): SPEVAK PHYSICAL THERAPY NEVADA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2011
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:
Mailing address:
  • Phone: 775-786-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL J SPEVAK
Title or Position: PRESIDENT
Credential: D.P.T., O.C.S.
Phone: 775-786-2400