Organization
LONGEVITY AND PERFORMANCE CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD MICHAEL REITER (OWNER)
(336) 442-9005
Entity
Organization
Contact information
Practice address
2475 HILLCREST CENTER CIR, WINSTON SALEM, NC 27103-3048
(336) 754-3500
Mailing address
64 ABBOTTSFORD DR, PINEHURST, NC 28374-9756
(336) 442-9005
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
07/14/2026
Last updated
07/14/2026
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