Provider Demographics
NPI:1881110450
Name:REICKS, HANNAH L (DPT)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:L
Last Name:REICKS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:L
Other - Last Name:REUTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2222
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:15703 PACIFIC AVE S STE B
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-4675
Practice Address - Country:US
Practice Address - Phone:253-531-4100
Practice Address - Fax:253-531-3795
Is Sole Proprietor?:No
Enumeration Date:2017-08-16
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60763980225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist