Provider Demographics
NPI:1336217009
Name:ANDERSON, PARLEY ISAAC (DPT)
Entity Type:Individual
Prefix:MR
First Name:PARLEY
Middle Name:ISAAC
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3594 W PLUMB LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3696
Mailing Address - Country:US
Mailing Address - Phone:775-786-2400
Mailing Address - Fax:775-786-2411
Practice Address - Street 1:3594 W PLUMB LN
Practice Address - Street 2:SUITE B
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3696
Practice Address - Country:US
Practice Address - Phone:775-786-2400
Practice Address - Fax:775-786-2411
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV17592251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100505650Medicaid
NV100505650Medicaid