Provider Demographics
NPI:1982637203
Name:REUSS, THOMAS STEVEN (MSPT)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:STEVEN
Last Name:REUSS
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 980
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:96022
Mailing Address - Country:US
Mailing Address - Phone:530-347-2220
Mailing Address - Fax:530-347-2227
Practice Address - Street 1:3254 MAIN STREET
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:CA
Practice Address - Zip Code:96022
Practice Address - Country:US
Practice Address - Phone:530-347-2220
Practice Address - Fax:530-347-2227
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT25699225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP52388Medicare UPIN
CA0PT256990Medicare ID - Type Unspecified
CA0PT256990Medicare PIN