Healthcare Provider Details

I. General information

NPI: 1154559441
Provider Name (Legal Business Name): MICHAEL SCOT REITH O.T.R., C.H.T
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 06/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2139 E BEECHWOOD AVE
FRESNO CA
93720-0340
US

IV. Provider business mailing address

2139 E BEECHWOOD AVE
FRESNO CA
93720-0340
US

V. Phone/Fax

Practice location:
  • Phone: 559-322-3350
  • Fax: 559-322-3353
Mailing address:
  • Phone: 559-322-3350
  • Fax: 559-322-3353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT 364
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: