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NPI Code Detail

MEDICARE: JESSICA ANNE ANDERSON PT, DPT

MEDICARE:   JESSICA ANNE ANDERSON  PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist3711NV

General Provider Information

NPI Number : 1124507025
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA ANNE ANDERSON PT, DPT
Provider Business Mailing Address
First Line : 3101 ABRUZZI CT
Second Line :
City : SPARKS
State : NV
Zip : 89434-9208
Country : US
Telephone Number : 856-264-3740
Fax Number :
Provider Business Practice Location Address
First Line : 1610 ROBB DR STE D5
Second Line :
City : RENO
State : NV
Zip : 89523-3520
Country : US
Telephone Number : 775-746-9222
Fax Number : 775-746-9224
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2018
Last Update Date : 09/17/2020

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Directions to “ JESSICA ANNE ANDERSON PT, DPT” Practice Location

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