Individual
MISS ELLEN REINHOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
521 LANCASTER AVE, RICHMOND, KY 40475
(616) 745-2685
Mailing address
3410 BROOKLYN AVE SE, GRAND RAPIDS, MI 49508-2440
(616) 745-2685
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200031315
BOC
—
Enumeration date
10/17/2016
Last updated
06/26/2018
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