Provider Demographics
NPI:1376638684
Name:HITTLE, REED A (PT)
Entity Type:Individual
Prefix:
First Name:REED
Middle Name:A
Last Name:HITTLE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 IOWA SE SUITE 105
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:SD
Mailing Address - Zip Code:57350
Mailing Address - Country:US
Mailing Address - Phone:605-352-2169
Mailing Address - Fax:605-352-9782
Practice Address - Street 1:530 IOWA SE SUITE 105
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:SD
Practice Address - Zip Code:57350
Practice Address - Country:US
Practice Address - Phone:605-352-2169
Practice Address - Fax:605-352-9782
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0152225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9230402OtherDAKOTACARE
SD5833072Medicaid
SD20677OtherSVHP
SD4994646OtherBCBS
SD4167890001OtherDME- CIGNA
SDA002OtherTRICARE
SDHA4001OtherTLC
SDA137603OtherMULTI-PLAN EOS
SD1923246OtherFIRST HEALTH
SD64-06449OtherMEDICA
SDHA4001OtherTLC