Provider Demographics
NPI:1003475179
Name:RIETHMAN, SCOTT ALAN
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ALAN
Last Name:RIETHMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14650 E SHELBY RD
Mailing Address - Street 2:
Mailing Address - City:MINSTER
Mailing Address - State:OH
Mailing Address - Zip Code:45865-9335
Mailing Address - Country:US
Mailing Address - Phone:937-658-8040
Mailing Address - Fax:
Practice Address - Street 1:14650 E SHELBY RD
Practice Address - Street 2:
Practice Address - City:MINSTER
Practice Address - State:OH
Practice Address - Zip Code:45865-9335
Practice Address - Country:US
Practice Address - Phone:937-658-8040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health