Provider Demographics
NPI:1508269325
Name:SEEWALD, JEANINE SIGAL (PTA)
Entity type:Individual
Prefix:
First Name:JEANINE
Middle Name:SIGAL
Last Name:SEEWALD
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:JEANINE
Other - Middle Name:
Other - Last Name:SIGAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5310 KIETZKE LN STE 104
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2043
Mailing Address - Country:US
Mailing Address - Phone:775-348-8800
Mailing Address - Fax:833-687-1419
Practice Address - Street 1:9480 DOUBLE DIAMOND PKWY STE 200
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-5842
Practice Address - Country:US
Practice Address - Phone:775-348-8800
Practice Address - Fax:833-687-1419
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-0756225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant