Provider Demographics
NPI:1225866841
Name:SALT AND LIGHT WELLNESS LLC
Entity type:Organization
Organization Name:SALT AND LIGHT WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-296-3336
Mailing Address - Street 1:3521 SMOKETREE AVE
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89705-8011
Mailing Address - Country:US
Mailing Address - Phone:775-277-3234
Mailing Address - Fax:775-277-3272
Practice Address - Street 1:10389 DOUBLE R BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-5991
Practice Address - Country:US
Practice Address - Phone:714-296-3336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy