Provider Demographics
NPI:1235467523
Name:LESTER, KEVIN FREDERICK (DPT)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:FREDERICK
Last Name:LESTER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 PLUMAS ST
Mailing Address - Street 2:STE 4
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3387
Mailing Address - Country:US
Mailing Address - Phone:775-683-9041
Mailing Address - Fax:775-683-9043
Practice Address - Street 1:1875 PLUMAS ST
Practice Address - Street 2:STE 4
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3387
Practice Address - Country:US
Practice Address - Phone:775-683-9041
Practice Address - Fax:775-683-9043
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3372225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC389ZMedicare PIN