=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932067634
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MTROSE FITNESS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/12/2026
-----------------------------------------------------
Last Update Date | 01/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8975 DOUBLE DIAMOND PKWY STE A12
-----------------------------------------------------
City | RENO
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89521-4846
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-790-0279
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 132 S C ST # 998
-----------------------------------------------------
City | VIRGINIA CITY
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89440-9800
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-790-0279
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | KATHERINE HUKARI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 775-790-0279
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------