Provider Demographics
NPI:1669906343
Name:MEDOPTIONS
Entity type:Organization
Organization Name:MEDOPTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRBY
Authorized Official - Middle Name:
Authorized Official - Last Name:REUTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-450-8986
Mailing Address - Street 1:422 E CANAL ST
Mailing Address - Street 2:
Mailing Address - City:ANTWERP
Mailing Address - State:OH
Mailing Address - Zip Code:45813-8425
Mailing Address - Country:US
Mailing Address - Phone:260-450-8986
Mailing Address - Fax:
Practice Address - Street 1:422 E CANAL ST
Practice Address - Street 2:
Practice Address - City:ANTWERP
Practice Address - State:OH
Practice Address - Zip Code:45813-8425
Practice Address - Country:US
Practice Address - Phone:260-450-8986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37448310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility