Basic Information
| Provider Information | |||||||||
| NPI: | 1699737841 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REID | ||||||||
| FirstName: | RAYMOND | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MSPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1181 AQUIDNECK AVE | ||||||||
| Address2: | OLYMPIC PHYSICAL THERAPY | ||||||||
| City: | MIDDLETOWN | ||||||||
| State: | RI | ||||||||
| PostalCode: | 02842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4018450840 | ||||||||
| FaxNumber: | 4018450842 | ||||||||
| Practice Location | |||||||||
| Address1: | 1181 AQUIDNECK AVE | ||||||||
| Address2: | OLYMPIC PHYSICAL THERAPY | ||||||||
| City: | MIDDLETOWN | ||||||||
| State: | RI | ||||||||
| PostalCode: | 02842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4018450840 | ||||||||
| FaxNumber: | 4018450842 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2006 | ||||||||
| LastUpdateDate: | 09/16/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT1044 | RI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.