Provider Demographics
NPI:1114513504
Name:REEVES, WILLIAM (LMT)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:REEVES
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 BISHOP DR
Mailing Address - Street 2:
Mailing Address - City:MILLBROOK
Mailing Address - State:AL
Mailing Address - Zip Code:36054-3356
Mailing Address - Country:US
Mailing Address - Phone:334-312-1094
Mailing Address - Fax:
Practice Address - Street 1:214 BISHOP DR
Practice Address - Street 2:
Practice Address - City:MILLBROOK
Practice Address - State:AL
Practice Address - Zip Code:36054-3356
Practice Address - Country:US
Practice Address - Phone:334-312-1094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-19
Last Update Date:2020-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3776225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist