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NPI Code Detail

MEDICARE: MTROSE FITNESS LLC

MEDICARE: MTROSE FITNESS 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
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1932067634
Entity Type Code : Organization
Provider Name (Legal Business Name) : MTROSE FITNESS LLC
Provider Business Mailing Address
First Line : 132 S C ST # 998
Second Line :
City : VIRGINIA CITY
State : NV
Zip : 89440-9800
Country : US
Telephone Number : 775-790-0279
Fax Number :
Provider Business Practice Location Address
First Line : 8975 DOUBLE DIAMOND PKWY STE A12
Second Line :
City : RENO
State : NV
Zip : 89521-4846
Country : US
Telephone Number : 775-790-0279
Fax Number :
Authorized Official
Title or Position : MANAGING MEMBER
Name : KATHERINE HUKARI
Credential :
Telephone Number : 775-790-0279
Provider Enumeration Date : 01/12/2026
Last Update Date : 01/12/2026

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Directions to “MTROSE FITNESS LLC ” Practice Location

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