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General NPI Number Information
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NPI Number | 1093821084
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Entity Type | Individual
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Provider Name | BRIAN JEFFREY REINKER A.T.C.
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Gender | Male
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8408 ROCHESTER AVE
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3904
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Country | US
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Telephone | 909-481-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1850 E MARQUETTE DR
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City | GILBERT
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State | AZ
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Zip | 85234-4914
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Country | US
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Telephone | 480-241-5792
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0500
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License Number State | AZ
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