MEDICARE: KEVIN FREDERICK LESTER 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
1	225100000X	Physical Therapist	3372	NV

General Provider Information

NPI Number	:	1235467523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN FREDERICK LESTER DPT

Provider Business Mailing Address
First Line	:	1875 PLUMAS ST
Second Line	:	STE 4
City	:	RENO
State	:	NV
Zip	:	89509-3387
Country	:	US
Telephone Number	:	775-683-9041
Fax Number	:	775-683-9043

Provider Business Practice Location Address
First Line	:	1875 PLUMAS ST
Second Line	:	STE 4
City	:	RENO
State	:	NV
Zip	:	89509-3387
Country	:	US
Telephone Number	:	775-683-9041
Fax Number	:	775-683-9043

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2009
Last Update Date	:	07/19/2022

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