Provider Demographics
NPI:1285696435
Name:BATES, RORY WAYNE (PT, DPT)
Entity type:Individual
Prefix:MR
First Name:RORY
Middle Name:WAYNE
Last Name:BATES
Suffix:
Gender:M
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 1:875 RAILROAD STREET
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801
Mailing Address - Country:US
Mailing Address - Phone:775-777-7722
Mailing Address - Fax:775-777-7900
Practice Address - Street 1:875 RAILROAD STREET
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801
Practice Address - Country:US
Practice Address - Phone:775-777-7722
Practice Address - Fax:775-777-7900
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1798225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV003404007Medicaid
V38224Medicare UPIN