Provider Demographics
NPI:1790447183
Name:REININK PHYSICAL THERAPY AND WELLNESS
Entity Type:Organization
Organization Name:REININK PHYSICAL THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FORD
Authorized Official - Middle Name:
Authorized Official - Last Name:REININK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-422-7172
Mailing Address - Street 1:714 144TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-1415
Mailing Address - Country:US
Mailing Address - Phone:616-422-7172
Mailing Address - Fax:
Practice Address - Street 1:714 144TH AVE
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-1415
Practice Address - Country:US
Practice Address - Phone:616-422-7172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty