| NPI | 1487097762 |
|---|---|
| Other Name | TY REIDENBAUGH |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MT MEDPHYSCOMLIC114707) |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2023-02-27 |