Provider Demographics
NPI:1255054102
Name:REIF, BARRETT ROBERT (DPT)
Entity type:Individual
Prefix:MR
First Name:BARRETT
Middle Name:ROBERT
Last Name:REIF
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1233 N NORTHWOOD CENTER CT STE 101
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-6190
Mailing Address - Country:US
Mailing Address - Phone:208-215-2450
Mailing Address - Fax:208-773-1473
Practice Address - Street 1:227 MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:EVELETH
Practice Address - State:MN
Practice Address - Zip Code:55734-1606
Practice Address - Country:US
Practice Address - Phone:218-481-7603
Practice Address - Fax:218-481-7601
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID9171049225100000X
MN12628225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist