Healthcare Provider Details

I. General information

NPI: 1750215646
Provider Name (Legal Business Name): EMI REETHOF DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 MONTREAL RD STE 100
TUCKER GA
30084-6919
US

IV. Provider business mailing address

1400 MONTREAL RD STE 100
TUCKER GA
30084-6919
US

V. Phone/Fax

Practice location:
  • Phone: 770-939-4360
  • Fax:
Mailing address:
  • Phone: 770-939-4360
  • Fax: 404-377-0011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR066703
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: