Provider Demographics
NPI:1508232760
Name:LESTER, KILEY (DPT)
Entity Type:Individual
Prefix:
First Name:KILEY
Middle Name:
Last Name:LESTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KILEY
Other - Middle Name:
Other - Last Name:LOVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1875 PLUMAS ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3379
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:SUITE 4
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3379
Practice Address - Country:US
Practice Address - Phone:775-683-9041
Practice Address - Fax:775-683-9043
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3417225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist