Basic Information
Provider Information
NPI: 1467452219
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REEVES
FirstName: HEATHER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 CRESCENT CENTRE DR STE 300
Address2:  
City: FRANKLIN
State: TN
PostalCode: 370677285
CountryCode: US
TelephoneNumber: 6153731350
FaxNumber: 6152219054
Practice Location
Address1: 115 KILDAIRE PARK DR STE 202
Address2:  
City: CARY
State: NC
PostalCode: 275188144
CountryCode: US
TelephoneNumber: 9192339557
FaxNumber: 9192339558
Other Information
ProviderEnumerationDate: 07/22/2005
LastUpdateDate: 01/29/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/29/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XP7145NCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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