MEDICARE: LARRY JOHN REUTZEL

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	332BX2000X	Oxygen Equipment & Supplies (DME)	332BX2000X	IA

General Provider Information

NPI Number	:	1386758100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY JOHN REUTZEL

Provider Business Mailing Address
First Line	:	617 8TH AVE SE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52401-2117
Country	:	US
Telephone Number	:	319-364-4181
Fax Number	:	319-363-5448

Provider Business Practice Location Address
First Line	:	617 8TH AVE SE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52401-2117
Country	:	US
Telephone Number	:	319-364-4181
Fax Number	:	319-363-5448

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

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	02/16/2012

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Directions to “ LARRY JOHN REUTZEL ” Practice Location

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