Organization
PHYSICAL THERAPY PARTNERS NEVADA LLC
Active
Other names
Soar Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BOYD A ETTER PT, DIP. MDT, OCS (OWNER)
(775) 853-7475
Entity
Organization
Contact information
Practice address
10775 DOUBLE R BLVD, 100, RENO, NV 89521-8956
(775) 853-7475
(775) 853-2013
Mailing address
415 US HIGHWAY 95A S, C302, FERNLEY, NV 89408-9261
(775) 575-1818
(775) 515-1808
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100505650
—
NV
01
—
V104480
MEDICARE PTAN
NV
Enumeration date
12/01/2006
Last updated
12/09/2011
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