Provider Demographics
NPI:1295756971
Name:EMM-REEDY, TERESA L (PT)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:L
Last Name:EMM-REEDY
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:PO BOX 426
Mailing Address - Street 2:4021 HWY 95 N
Mailing Address - City:SCHURZ
Mailing Address - State:NV
Mailing Address - Zip Code:89427-0426
Mailing Address - Country:US
Mailing Address - Phone:775-945-2298
Mailing Address - Fax:775-945-2262
Practice Address - Street 1:4021 HWY 95 N
Practice Address - Street 2:
Practice Address - City:SCHURZ
Practice Address - State:NV
Practice Address - Zip Code:89427-0426
Practice Address - Country:US
Practice Address - Phone:775-945-2298
Practice Address - Fax:775-945-2262
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0632174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV003411001Medicaid
NV003411001Medicaid
NVV34352Medicare PIN