MEDICARE: JANET REYES P.T.

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	20396	CA

General Provider Information

NPI Number	:	1386956753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET REYES P.T.

Provider Business Mailing Address
First Line	:	6906 PLATT AVE
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-2437
Country	:	US
Telephone Number	:	818-746-1280
Fax Number	:

Provider Business Practice Location Address
First Line	:	6906 PLATT AVE
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-2437
Country	:	US
Telephone Number	:	818-746-1280
Fax Number	:

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

Provider Enumeration Date	:	07/13/2010
Last Update Date	:	07/13/2010

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