Healthcare Provider Details

I. General information

NPI: 1902035165
Provider Name (Legal Business Name): JEAN REINHARDT RPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2009
Last Update Date: 07/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87086 DUKHOBAR RD
EUGENE OR
97402-9267
US

IV. Provider business mailing address

87086 DUKHOBAR RD
EUGENE OR
97402-9267
US

V. Phone/Fax

Practice location:
  • Phone: 541-342-6605
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1024
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: