Healthcare Provider Details

I. General information

NPI: 1013933894
Provider Name (Legal Business Name): STEVEN R. RIEGEL PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 02/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 JENKINS MEMORIAL RD
WELLSTON OH
45692-9561
US

IV. Provider business mailing address

21 BROAD ST
JACKSON OH
45640-1604
US

V. Phone/Fax

Practice location:
  • Phone: 740-384-2167
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number009703
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: