Provider Demographics
NPI:1063818730
Name:REINHARD, MICHAEL SCOTT (LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:SCOTT
Last Name:REINHARD
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:898 WOODBERRY FOREST RD
Mailing Address - Street 2:
Mailing Address - City:WOODBERRY FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:22989-8002
Mailing Address - Country:US
Mailing Address - Phone:540-672-6726
Mailing Address - Fax:
Practice Address - Street 1:898 WOODBERRY FOREST RD
Practice Address - Street 2:
Practice Address - City:WOODBERRY FOREST
Practice Address - State:VA
Practice Address - Zip Code:22989-8002
Practice Address - Country:US
Practice Address - Phone:540-672-6726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-07
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260026022255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer