Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 070.023654 | IL |
Y | 225100000X | Physical Therapist | PT35527 | FL |
NPI | 1013400993 |
---|---|
Provider Name | Michael D Reuland |
First Address | Dekalb, IL 60115-2470 |
Second Address | Dekalb, IL 60115-2470 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2018 |
Last Update Date | 22/01/2021 |