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NPI Code Detail

MEDICARE: BRADLEY SCOTT REYMAN PT

MEDICARE: BRADLEY SCOTT REYMAN 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
1225100000XPhysical Therapist2858OK

General Provider Information

NPI Number : 1962494773
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRADLEY SCOTT REYMAN PT
Provider Business Mailing Address
First Line : 12545 W READE AVE
Second Line :
City : LITCHFIELD PARK
State : AZ
Zip : 85340-4125
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7219 N LITCHFIELD RD
Second Line : 56TH MDG/MDOS
City : LUKE AFB
State : AZ
Zip : 85309-1529
Country : US
Telephone Number : 623-856-9094
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2005
Last Update Date : 07/08/2007

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Directions to “ BRADLEY SCOTT REYMAN PT” Practice Location

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