Healthcare Provider Details

I. General information

NPI: 1053468702
Provider Name (Legal Business Name): LINDA LAFFERTY, D.O., LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6580 S MCCARRAN BLVD SUITE A
RENO NV
89509-6112
US

IV. Provider business mailing address

6580 S MCCARRAN BLVD SUITE A
RENO NV
89509-6112
US

V. Phone/Fax

Practice location:
  • Phone: 775-828-5100
  • Fax:
Mailing address:
  • Phone: 775-828-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License NumberNV0366
License Number StateNV

VIII. Authorized Official

Name: DR. LINDA LAFFERTY
Title or Position: DR.
Credential: D. O.
Phone: 775-828-5100