Provider Demographics
NPI:1689833907
Name:REIGHARD, BRION DALE (PT)
Entity Type:Individual
Prefix:
First Name:BRION
Middle Name:DALE
Last Name:REIGHARD
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 1:6415 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-4121
Mailing Address - Country:US
Mailing Address - Phone:509-327-4867
Mailing Address - Fax:509-327-0542
Practice Address - Street 1:6415 N MONROE ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-4121
Practice Address - Country:US
Practice Address - Phone:509-327-4867
Practice Address - Fax:509-327-0542
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008690225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist