Basic Information
| Provider Information | |||||||||
| NPI: | 1639482953 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REICHHOFF | ||||||||
| FirstName: | ANNE | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4901 COTTAGE GROVE RD | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537161392 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6082211505 | ||||||||
| FaxNumber: | 6082233540 | ||||||||
| Practice Location | |||||||||
| Address1: | 4901 COTTAGE GROVE RD | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537161392 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6082211505 | ||||||||
| FaxNumber: | 6082233540 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2010 | ||||||||
| LastUpdateDate: | 11/02/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 11532-24 | WI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 11532-24 | 01 | WI | WI STATE LICENSE | OTHER |