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General NPI Number Information
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NPI Number | 1790074615
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Entity Type | Organization
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Legal Business Name | SYNERGY PHYSICAL THERAPY & FITNESS, LLC
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Dates
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Enumeration Date | 03/31/2011
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Last Update Date | 03/31/2011
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Provider Practice Location Address
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Address Line | 626 HUMBOLT ST.
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City | RENO
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State | NV
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Zip | 89509
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Country | US
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Telephone | 775-323-4325
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Fax | 775-323-4325
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Provider Business Mailing Address
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Address Line | P.O. BOX 61210
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City | RENO
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State | NV
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Zip | 89508
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Country | US
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Telephone | 775-323-4325
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Fax | 775-323-4325
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DENISE A MONTAGNE
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Credential | P.T.
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Telephone | 775-323-4325
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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 | NV
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