Healthcare Provider Details

I. General information

NPI: 1962948067
Provider Name (Legal Business Name): HANNA REINHART
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2017
Last Update Date: 01/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 MEMORIAL DRIVE SUITE 7699
CULLOWHEE NC
28723
US

IV. Provider business mailing address

6415 GALLERY DRIVE
CANTON MI
48187
US

V. Phone/Fax

Practice location:
  • Phone: 734-812-6587
  • Fax:
Mailing address:
  • Phone: 734-812-6587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberR563298115437
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberR563298115437
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: