Provider Demographics
NPI:1932391380
Name:OMEGA THERAPY SERVICES
Entity Type:Organization
Organization Name:OMEGA THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:KARL
Authorized Official - Last Name:REISECK
Authorized Official - Suffix:
Authorized Official - Credentials:CH
Authorized Official - Phone:305-231-4836
Mailing Address - Street 1:2750 W 68TH ST STE 203
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5450
Mailing Address - Country:US
Mailing Address - Phone:305-231-4836
Mailing Address - Fax:305-231-4838
Practice Address - Street 1:2750 W 68TH ST STE 203
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5450
Practice Address - Country:US
Practice Address - Phone:305-231-4836
Practice Address - Fax:305-231-4838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty