Provider Demographics
NPI:1265574347
Name:REESE, STEPHANIE RAE (PT)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:RAE
Last Name:REESE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 VISTA VIEW DR
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-5812
Mailing Address - Country:US
Mailing Address - Phone:970-209-4014
Mailing Address - Fax:
Practice Address - Street 1:114 APOLLO RD
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-4857
Practice Address - Country:US
Practice Address - Phone:970-249-6920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9137225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist