Provider Demographics
NPI:1003598541
Name:FOX, REYNA YURITZIA (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:REYNA
Middle Name:YURITZIA
Last Name:FOX
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:REYNA
Other - Middle Name:YURITZIA
Other - Last Name:VERANO GILLIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9019 LANDSBURG LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-7673
Mailing Address - Country:US
Mailing Address - Phone:321-372-4010
Mailing Address - Fax:
Practice Address - Street 1:3442 CYPRESS CLUB DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-2467
Practice Address - Country:US
Practice Address - Phone:704-714-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP22460225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist