Individual
MICHELLE METTE FORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
9480 DOUBLE DIAMOND PKWY STE 200, RENO, NV 89521-5842
(775) 348-8800
(833) 687-1419
Mailing address
5310 KIETZKE LN STE 104, RENO, NV 89511-2043
(775) 348-8800
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3465
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3465
NEVADA STATE LICENSE
NV
01
—
37229
CA LICENSE
CA
Enumeration date
07/01/2019
Last updated
03/31/2025
About Stedi
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