Provider Demographics
NPI:1154559441
Name:REITH, MICHAEL SCOT (OTR, CHT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:SCOT
Last Name:REITH
Suffix:
Gender:M
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2139 E BEECHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0340
Mailing Address - Country:US
Mailing Address - Phone:559-322-3350
Mailing Address - Fax:559-322-3353
Practice Address - Street 1:2139 E BEECHWOOD AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-0340
Practice Address - Country:US
Practice Address - Phone:559-322-3350
Practice Address - Fax:559-322-3353
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 364225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand