Provider Demographics
NPI:1033678560
Name:REAP, PALMER (DPT)
Entity Type:Individual
Prefix:
First Name:PALMER
Middle Name:
Last Name:REAP
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7205 ESTERO BLVD UNIT 5
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33931-4786
Mailing Address - Country:US
Mailing Address - Phone:239-314-5118
Mailing Address - Fax:
Practice Address - Street 1:7205 ESTERO BLVD UNIT 5
Practice Address - Street 2:
Practice Address - City:FORT MYERS BEACH
Practice Address - State:FL
Practice Address - Zip Code:33931-4786
Practice Address - Country:US
Practice Address - Phone:239-314-5118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT34445225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist