Provider Demographics
NPI:1598986366
Name:BODNER, CATHERINE A (PT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:BODNER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16005 CHOKECHERRY LANE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9460 DOUBLE R BLVD
Practice Address - Street 2:101
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-6020
Practice Address - Country:US
Practice Address - Phone:775-284-8650
Practice Address - Fax:775-284-8654
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist