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General NPI Number Information
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NPI Number | 1184845984
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Entity Type | Organization
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Legal Business Name | DR.LLOYD CHARLES REITER, D.C. P.C.
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 1731 N OCEAN AVE SUITE C
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City | MEDFORD
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State | NY
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Zip | 11763-2670
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Country | US
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Telephone | 631-758-8770
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Fax | 631-758-8769
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Provider Business Mailing Address
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Address Line | 1731 N OCEAN AVE SUITE C
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City | MEDFORD
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State | NY
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Zip | 11763-2670
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Country | US
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Telephone | 631-758-8770
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Fax | 631-758-8769
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. LLOYD CHARLES REITER
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Credential | D.C.
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Telephone | 631-758-8770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4384-1
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License Number State | NY
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