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General NPI Number Information
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NPI Number | 1144972886
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Entity Type | Individual
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Provider Name | ERIC MICHAEL REITZ M.ED.
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Gender | Male
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Dates
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Enumeration Date | 01/24/2022
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Last Update Date | 01/24/2022
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Provider Practice Location Address
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Address Line | 2924 EMERYWOOD PKWY STE 200
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City | RICHMOND
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State | VA
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Zip | 23294-3746
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Country | US
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Telephone | 804-346-5165
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Fax |
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Provider Business Mailing Address
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Address Line | 5310 LEE AVE
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City | RICHMOND
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State | VA
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Zip | 23226-1130
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Country | US
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Telephone | 610-858-5269
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0704014547
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License Number State | VA
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