MEDICARE: SIERRA ORTHOPAEDIC PHYSICAL THERAPY, LLC

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	261QP2000X	Physical Therapy Clinic/Center	3372	NV

General Provider Information

NPI Number	:	1871037200
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIERRA ORTHOPAEDIC PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	1875 PLUMAS ST
Second Line	:	SUITE 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	:	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	:	MANAGER, PHYSICAL THERAPIST
Name	:	KEVIN LESTER
Credential	:
Telephone Number	:	775-683-9041

Provider Enumeration Date	:	12/04/2016
Last Update Date	:	07/19/2022

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