Individual
MELISSA T KALISVAART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
10587 DOUBLE R BLVD STE 101, RENO, NV 89521-8966
(775) 324-5371
(775) 852-5373
Mailing address
10587 DOUBLE R BLVD STE 101, RENO, NV 89521-8966
(775) 324-5371
(775) 852-5373
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3236
NV
225100000X
Physical Therapist
8166
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
05
—
ENROLLED
—
NV
01
—
P00992409
MEDICARE RAILROAD
MN
Enumeration date
07/03/2008
Last updated
01/17/2020
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