Provider Demographics
NPI:1639167414
Name:HASSE, DAVID F (MSPT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:F
Last Name:HASSE
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 N ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4724
Mailing Address - Country:US
Mailing Address - Phone:775-788-5242
Mailing Address - Fax:775-786-6942
Practice Address - Street 1:555 N ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4724
Practice Address - Country:US
Practice Address - Phone:775-788-5242
Practice Address - Fax:775-786-6942
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1085225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV3416197Medicaid
NV35899Medicare ID - Type Unspecified
NV3416197Medicaid