Healthcare Provider Details

I. General information

NPI: 1427486463
Provider Name (Legal Business Name): ROBERT RICHARD RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2013
Last Update Date: 10/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 MILL ST
RENO NV
89502-1413
US

IV. Provider business mailing address

850 MILL ST
RENO NV
89502-1413
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-3941
  • Fax: 775-982-3959
Mailing address:
  • Phone: 775-982-3941
  • Fax: 775-982-3959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279P1005X
TaxonomyPulmonary Rehabilitation Registered Respiratory Therapist
License NumberRC216
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: