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NPI Code Detail

MEDICARE: CHARLES REITZ

MEDICARE: CHARLES REITZ
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 Therapist3307-024WI

General Provider Information

NPI Number : 1215137989
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES REITZ
Provider Business Mailing Address
First Line : 10731 W FOREST HOME AVE
Second Line :
City : HALES CORNERS
State : WI
Zip : 53130-2555
Country : US
Telephone Number : 414-529-4605
Fax Number :
Provider Business Practice Location Address
First Line : 10731 W FOREST HOME AVE
Second Line :
City : HALES CORNERS
State : WI
Zip : 53130-2555
Country : US
Telephone Number : 414-529-4605
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2007
Last Update Date : 10/01/2007

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Directions to “ CHARLES REITZ ” Practice Location

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