Provider Demographics
NPI:1114970746
Name:REELS, FELICIA NICOLE (PT DPT)
Entity Type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:NICOLE
Last Name:REELS
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:NICOLE
Other - Last Name:COLON-BARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT DPT
Mailing Address - Street 1:200 N ROBERTSON BLVD
Mailing Address - Street 2:# 301
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1769
Mailing Address - Country:US
Mailing Address - Phone:310-273-8256
Mailing Address - Fax:310-273-8542
Practice Address - Street 1:200 N ROBERTSON BLVD
Practice Address - Street 2:# 301
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1769
Practice Address - Country:US
Practice Address - Phone:310-273-8256
Practice Address - Fax:310-273-8542
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT32193225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q57030Medicare UPIN
CAWPT32193AMedicare ID - Type Unspecified