Doctor Name: | ALEX G REISH |
NPI Number: | 1760694525 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | 46517 |
Business Practice Address: | 5387 Manhattan Cir Suite 201 Boulder, CO - 803034284 |
Business Phone Number: | 3034942705 |
Business Fax Number: | 3034942706 |
Mailing Address: | 5387 Manhattan Cir, Suite 201 BOULDER |
State: | CO |
Postal Code: | 803034284 |
Phone Number: | 3034942705 |
Fax Number: | 3034942706 |
NPI Enumeration Date: | 05/04/2007 |
NPI Last Update Date: | 12/09/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204D00000X |
License Number: | 46517 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
Taxonomy Specialization: | |
Taxonomy Definition: |