Healthcare Provider Details

I. General information

NPI: 1760806251
Provider Name (Legal Business Name): ALLISON A REINES RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALLISON A REINES RRT

II. Dates (important events)

Enumeration Date: 02/05/2014
Last Update Date: 02/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 N JACKSON AVE
SAN JOSE CA
95116-1603
US

IV. Provider business mailing address

PO BOX 2617
BIGFORK MT
59911-2617
US

V. Phone/Fax

Practice location:
  • Phone: 408-259-5000
  • Fax:
Mailing address:
  • Phone: 406-212-6190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRCP 34637
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: