MEDICARE: KILEY 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	3417	NV

General Provider Information

NPI Number	:	1508232760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KILEY LESTER DPT

Provider Business Mailing Address
First Line	:	1875 PLUMAS ST
Second Line	:	SUITE 4
City	:	RENO
State	:	NV
Zip	:	89509-3379
Country	:	US
Telephone Number	:	775-683-9041
Fax Number	:	775-683-9043

Provider Business Practice Location Address
First Line	:	1875 PLUMAS ST
Second Line	:	SUITE 4
City	:	RENO
State	:	NV
Zip	:	89509-3379
Country	:	US
Telephone Number	:	775-683-9041
Fax Number	:	775-683-9043

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

Provider Enumeration Date	:	08/11/2015
Last Update Date	:	01/09/2017

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Directions to “ KILEY LESTER DPT” Practice Location

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