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General NPI Number Information
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NPI Number | 1861766800
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Entity Type | Individual
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Provider Name | ELIZABETH A GERTON
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Gender | Female
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Dates
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Enumeration Date | 03/07/2012
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Last Update Date | 03/11/2015
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Provider Practice Location Address
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Address Line | 111 W TELEGRAPH ST STE 204
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City | CARSON CITY
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State | NV
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Zip | 89703-4266
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Country | US
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Telephone | 775-434-8183
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Fax | 440-580-7025
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Provider Business Mailing Address
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Address Line | 1046 AL TAHOE BLVD
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150-4603
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Country | US
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Telephone | 775-434-8183
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Fax | 440-580-7025
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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