Provider Demographics
NPI:1245696202
Name:REITER, BRIDGET R (RD)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:R
Last Name:REITER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 MIDTOWN PARK E
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-4141
Mailing Address - Country:US
Mailing Address - Phone:251-478-2233
Mailing Address - Fax:877-816-0592
Practice Address - Street 1:55 MIDTOWN PARK E
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-4141
Practice Address - Country:US
Practice Address - Phone:251-478-2233
Practice Address - Fax:877-816-0592
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2290133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered