Provider Demographics
NPI:1588682819
Name:REIFF, RALPH VICTOR (LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:VICTOR
Last Name:REIFF
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 1:4335 ASHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-1770
Mailing Address - Country:US
Mailing Address - Phone:317-415-5747
Mailing Address - Fax:317-415-5748
Practice Address - Street 1:4335 ASHWOOD DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1770
Practice Address - Country:US
Practice Address - Phone:317-415-5747
Practice Address - Fax:317-415-5748
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36000054A174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist