Provider Demographics
NPI:1376504191
Name:REEVES, JULIE ORDELT (PT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ORDELT
Last Name:REEVES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:MICHELLE
Other - Last Name:ORDELT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2065 MCDADE RD
Mailing Address - Street 2:
Mailing Address - City:HEPHZIBAH
Mailing Address - State:GA
Mailing Address - Zip Code:30815-4721
Mailing Address - Country:US
Mailing Address - Phone:706-592-6396
Mailing Address - Fax:706-592-6872
Practice Address - Street 1:2065 MCDADE RD
Practice Address - Street 2:
Practice Address - City:HEPHZIBAH
Practice Address - State:GA
Practice Address - Zip Code:30815-4721
Practice Address - Country:US
Practice Address - Phone:706-592-6396
Practice Address - Fax:706-592-6872
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008635225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics