Provider Demographics
NPI:1003171646
Name:CATES, ABBY GENE (PTA)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:GENE
Last Name:CATES
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 TAHOE BLVD
Mailing Address - Street 2:
Mailing Address - City:INCLINE VILLAGE
Mailing Address - State:NV
Mailing Address - Zip Code:89451-9795
Mailing Address - Country:US
Mailing Address - Phone:801-589-4212
Mailing Address - Fax:
Practice Address - Street 1:3050 N ORMSBY BLVD
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-8378
Practice Address - Country:US
Practice Address - Phone:775-841-4646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-0608225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant