Provider Demographics
NPI:1871589077
Name:REEL, DENISE LYNN (PT)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:LYNN
Last Name:REEL
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 1:4540 JOHN F KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-7309
Mailing Address - Country:US
Mailing Address - Phone:501-758-5555
Mailing Address - Fax:501-758-5941
Practice Address - Street 1:4540 JOHN F KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-7309
Practice Address - Country:US
Practice Address - Phone:501-758-5555
Practice Address - Fax:501-758-5941
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT933225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARP00068469OtherRAILROAD MEDICARE
AS5X462OtherBC/BS PROVIDER NUMBER
AR5X462Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER