Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 119734 | MO |
NPI | 1326012568 |
---|---|
Provider Name | Mark F Reinking |
First Address | Denver, CO 80211-1963 |
Second Address | Denver, CO 80221-1154 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 17/09/2015 |