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General NPI Number Information
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NPI Number | 1104460450
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY ON THE GO LLC
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Dates
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Enumeration Date | 10/30/2019
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 10200 TIMBERWOLF DR
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City | RENO
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State | NV
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Zip | 89523-9664
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Country | US
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Telephone | 775-440-3706
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Fax | 775-204-9774
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Provider Business Mailing Address
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Address Line | PO BOX 33296
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City | RENO
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State | NV
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Zip | 89533-3296
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Country | US
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Telephone | 775-440-3706
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Fax | 775-204-9774
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Authorized Official
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Title or Position | OWNER, MANAGING MEMBER
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Name | NOELLE NATALE MADRASO
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Credential | PT
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Telephone | 775-440-3706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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