Provider Demographics
NPI:1376574210
Name:REEDER, MELODI AMBER (PT, MPT)
Entity Type:Individual
Prefix:
First Name:MELODI
Middle Name:AMBER
Last Name:REEDER
Suffix:
Gender:F
Credentials:PT, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4413 82ND ST.
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-3366
Mailing Address - Country:US
Mailing Address - Phone:806-319-7488
Mailing Address - Fax:806-368-5935
Practice Address - Street 1:4413 82ND ST.
Practice Address - Street 2:SUITE 107
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-3366
Practice Address - Country:US
Practice Address - Phone:806-319-7488
Practice Address - Fax:806-368-5935
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1135481225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist