Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT1206 | FL |
NPI | 1003087420 |
---|---|
Provider Name | Eugene A. Reiff |
First Address | Stuart, FL 34997-9116 |
Second Address | Jupiter, FL 33458-8207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2008 |
Last Update Date | 25/04/2012 |