Provider Demographics
NPI:1437421963
Name:KENNETH R. REINHART D.C. PA
Entity type:Organization
Organization Name:KENNETH R. REINHART D.C. PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:REINHART
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-822-2233
Mailing Address - Street 1:3190 MLK STREET N.
Mailing Address - Street 2:
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704
Mailing Address - Country:US
Mailing Address - Phone:727-822-2233
Mailing Address - Fax:727-894-3476
Practice Address - Street 1:3190 MLK STREET N.
Practice Address - Street 2:
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704
Practice Address - Country:US
Practice Address - Phone:727-822-2233
Practice Address - Fax:727-894-3476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5728111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T96187Medicare UPIN
22484Medicare PIN