Provider Demographics
NPI:1538424015
Name:REITER, KEVIN P (ATC)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:P
Last Name:REITER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 WESTERN AVE.
Mailing Address - Street 2:SUITE B
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-0239
Mailing Address - Country:US
Mailing Address - Phone:419-422-5526
Mailing Address - Fax:419-422-5562
Practice Address - Street 1:1725 WESTERN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-0239
Practice Address - Country:US
Practice Address - Phone:419-422-5526
Practice Address - Fax:419-422-5562
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT.0008862255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer