Healthcare Provider Details
I. General information
NPI: 1487075438
Provider Name (Legal Business Name): ORTHOPRO OF RENO INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/18/2013
Last Update Date: 06/08/2021
Certification Date: 06/08/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3195 MILL ST
RENO NV
89502-2201
US
IV. Provider business mailing address
3195 MILL ST
RENO NV
89502-2201
US
V. Phone/Fax
- Phone: 775-324-1443
- Fax: 775-324-1663
- Phone: 775-324-1443
- Fax: 775-324-1663
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | NV |
VIII. Authorized Official
Name:
KASSITY
TESSERS
Title or Position: OFFICE MANAGER
Credential:
Phone: 775-324-1443