Provider Demographics
NPI:1649519166
Name:REINS FOR LIFE INC
Entity type:Organization
Organization Name:REINS FOR LIFE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-626-2142
Mailing Address - Street 1:370 CADDO RD
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:NM
Mailing Address - Zip Code:88230-9650
Mailing Address - Country:US
Mailing Address - Phone:575-624-2095
Mailing Address - Fax:575-627-5721
Practice Address - Street 1:370 CADDO RD
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:NM
Practice Address - Zip Code:88230-9650
Practice Address - Country:US
Practice Address - Phone:575-624-2095
Practice Address - Fax:575-627-5721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty