Provider Demographics
NPI:1861793473
Name:REITZ, CLARA SUSAN (PT)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:SUSAN
Last Name:REITZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 BUCHANAN STREET
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-3566
Mailing Address - Country:US
Mailing Address - Phone:540-887-8007
Mailing Address - Fax:540-887-8004
Practice Address - Street 1:302 BUCHANAN STREET
Practice Address - Street 2:AUGUSTA PHYSCIAL THERAPY
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401
Practice Address - Country:US
Practice Address - Phone:540-887-8007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305001738225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist