Provider Demographics
NPI:1447700281
Name:REINARD, AMARAE
Entity type:Individual
Prefix:
First Name:AMARAE
Middle Name:
Last Name:REINARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1990 VAUGHN RD NW
Mailing Address - Street 2:SUITE 330
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-7098
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1990 VAUGHN RD NW
Practice Address - Street 2:SUITE 330
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-7098
Practice Address - Country:US
Practice Address - Phone:678-403-3632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTT31965225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist