Provider Demographics
NPI:1699039917
Name:BYRNE, JAMIE MARIE (DPT)
Entity Type:Individual
Prefix:MISS
First Name:JAMIE
Middle Name:MARIE
Last Name:BYRNE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89501-1714
Mailing Address - Country:US
Mailing Address - Phone:775-772-4298
Mailing Address - Fax:
Practice Address - Street 1:1561 S VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-2819
Practice Address - Country:US
Practice Address - Phone:775-322-4555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2593225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist