| Doctor Name: | KOTA BLAISE REICHERT |
| NPI Number: | 1962711515 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT, CSCS |
| License Number: | 34782 |
| Business Practice Address: | 300 Pasteur Drive H3124, M/c5284 Stanford, CA - 94305 |
| Business Phone Number: | 6504986433 |
| Business Fax Number: | |
| Mailing Address: | 2 Kofman Ct., ALAMEDA |
| State: | CA |
| Postal Code: | 94502 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/30/2010 |
| NPI Last Update Date: | 09/30/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 34782 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |