Provider Demographics
NPI:1427619261
Name:SESTANOVICH, MELISSA (PT, DPT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SESTANOVICH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:DAMELE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:2001 ERRECART BLVD
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-8333
Mailing Address - Country:US
Mailing Address - Phone:775-748-2086
Mailing Address - Fax:775-748-2087
Practice Address - Street 1:2001 ERRECART BLVD
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-8333
Practice Address - Country:US
Practice Address - Phone:775-748-2086
Practice Address - Fax:775-748-2087
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4035225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist