Provider Demographics
NPI:1871764647
Name:MANNING, KATIE L (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:L
Last Name:MANNING
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 ROBB DR STE 103
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-3733
Mailing Address - Country:US
Mailing Address - Phone:775-787-3733
Mailing Address - Fax:775-787-3744
Practice Address - Street 1:720 ROBB DR STE 103
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-3733
Practice Address - Country:US
Practice Address - Phone:775-787-3733
Practice Address - Fax:775-787-3744
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7748225100000X
NV2444225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist