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NPI Code Detail

MEDICARE: LINDA REILLY PT

MEDICARE: LINDA REILLY PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2348CO

General Provider Information

NPI Number : 1154528131
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA REILLY PT
Provider Business Mailing Address
First Line : 1321 ALENE CIR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-9329
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1321 ALENE CIR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-9329
Country : US
Telephone Number : 970-203-1116
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2007
Last Update Date : 07/08/2007

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