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NPI Code Detail

MEDICARE: ANGELA MARIE REITER PTA

MEDICARE: ANGELA MARIE REITER PTA
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
1225200000XPhysical Therapy AssistantA778IA

General Provider Information

NPI Number : 1205066552
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA MARIE REITER PTA
Provider Business Mailing Address
First Line : 815 FOREST AVE
Second Line :
City : NORTHFIELD
State : MN
Zip : 55057-1643
Country : US
Telephone Number : 507-664-8841
Fax Number :
Provider Business Practice Location Address
First Line : 815 FOREST AVE
Second Line :
City : NORTHFIELD
State : MN
Zip : 55057-1643
Country : US
Telephone Number : 507-664-8841
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2009
Last Update Date : 07/21/2009

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