Provider Demographics
NPI:1487480216
Name:PUSATERO, ANDREA (LMT)
Entity type:Individual
Prefix:MISS
First Name:ANDREA
Middle Name:
Last Name:PUSATERO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:NV
Mailing Address - Zip Code:89403-6357
Mailing Address - Country:US
Mailing Address - Phone:775-225-9523
Mailing Address - Fax:
Practice Address - Street 1:127 CREEKSIDE DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:NV
Practice Address - Zip Code:89403-6357
Practice Address - Country:US
Practice Address - Phone:775-225-9523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12429172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist