Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NR0400X | Rehabilitation Chiropractor | 3777 | NC |
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 2009-01103 | NC |
NPI | 1194917732 |
---|---|
Provider Name | Dr. Todd Michael Reiter |
First Address | Charlotte, NC 28260-0447 |
Second Address | Winston Salem, NC 27103-6946 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2007 |
Last Update Date | 25/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5917822 | (05) | NC |