MEDICARE: DR. MICHAEL ALLEN REETZ JR. PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT36565	FL

General Provider Information

NPI Number	:	1003557521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL ALLEN REETZ JR. PT

Provider Business Mailing Address
First Line	:	9361 BUCK HAVEN TRL
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32312-4106
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2819 CAPITAL MEDICAL BLVD
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-4405
Country	:	US
Telephone Number	:	850-325-5269
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2022
Last Update Date	:	04/06/2022

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