MEDICARE: JEFFREY A REINING DR.

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	101YM0800X	Mental Health Counselor
2	103T00000X	Psychologist

General Provider Information

NPI Number	:	1073949574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY A REINING DR.

Provider Business Mailing Address
First Line	:	641 SPENCER ST NE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49505-5207
Country	:	US
Telephone Number	:	815-355-1403
Fax Number	:

Provider Business Practice Location Address
First Line	:	641 SPENCER ST NE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49505-5207
Country	:	US
Telephone Number	:	815-355-1403
Fax Number	:

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

Provider Enumeration Date	:	09/17/2013
Last Update Date	:	09/29/2016

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