Provider Demographics
NPI:1982607800
Name:ORTHOPRO OF RENO, INC.
Entity Type:Organization
Organization Name:ORTHOPRO OF RENO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KASSITY
Authorized Official - Middle Name:
Authorized Official - Last Name:TESSERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-324-1443
Mailing Address - Street 1:3195 MILL ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-2201
Mailing Address - Country:US
Mailing Address - Phone:775-324-1443
Mailing Address - Fax:775-324-1663
Practice Address - Street 1:3195 MILL ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-2201
Practice Address - Country:US
Practice Address - Phone:775-324-1443
Practice Address - Fax:775-324-1663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100502693Medicaid
NV5106400001Medicare NSC