MEDICARE: KRISTOPHER REILLY PT, DPT

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	5501304603	MI

General Provider Information

NPI Number	:	1093640492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTOPHER REILLY PT, DPT

Provider Business Mailing Address
First Line	:	1422 W DAWSON RD
Second Line	:
City	:	MILFORD
State	:	MI
Zip	:	48381-2601
Country	:	US
Telephone Number	:	248-202-8837
Fax Number	:

Provider Business Practice Location Address
First Line	:	740 W GRAND RIVER AVE
Second Line	:
City	:	BRIGHTON
State	:	MI
Zip	:	48116-2392
Country	:	US
Telephone Number	:	810-227-3588
Fax Number	:

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

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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