Provider Demographics
NPI:1417278052
Name:GEMPERLE, PAUL MICHAEL (PTA)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:MICHAEL
Last Name:GEMPERLE
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3964 GLENVIEW TER
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-1859
Mailing Address - Country:US
Mailing Address - Phone:775-331-2878
Mailing Address - Fax:775-331-2878
Practice Address - Street 1:2045 SILVERADA BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512-2051
Practice Address - Country:US
Practice Address - Phone:775-359-3161
Practice Address - Fax:775-331-2878
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-0281225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVA-0281OtherNEVADA STATE BOARD OF PHYSICAL THERAPY EXAMINERS