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General NPI Number Information
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NPI Number | 1245879105
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Entity Type | Individual
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Provider Name | SKYE PAULY REINKING PT
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Gender | Female
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Dates
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Enumeration Date | 12/24/2019
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 245 RAVEN RD SUITE B
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City | KETCHUM
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State | ID
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Zip | 83340
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Country | US
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Telephone | 208-726-7246
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7063
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City | KETCHUM
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State | ID
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Zip | 83340-7063
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Country | US
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Telephone | 509-393-0886
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT-8497
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License Number State | ID
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