Provider Demographics
NPI:1669296471
Name:REIHS, ERICK
Entity type:Individual
Prefix:
First Name:ERICK
Middle Name:
Last Name:REIHS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ERICK
Other - Middle Name:
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1616 MARKET PLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-7927
Mailing Address - Country:US
Mailing Address - Phone:770-886-6354
Mailing Address - Fax:
Practice Address - Street 1:1616 MARKET PLACE BLVD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7927
Practice Address - Country:US
Practice Address - Phone:770-886-6354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-09
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADS001140237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist