Provider Demographics
NPI:1932383585
Name:ORAVITZ, MATTHEW STEPHEN
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:STEPHEN
Last Name:ORAVITZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 PLUMAS ST
Mailing Address - Street 2:201
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89519-6058
Mailing Address - Country:US
Mailing Address - Phone:610-390-1111
Mailing Address - Fax:
Practice Address - Street 1:6100 PLUMAS ST
Practice Address - Street 2:STE 201
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89519-6064
Practice Address - Country:US
Practice Address - Phone:610-390-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-18
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV29282251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic