Provider Demographics
NPI:1467465377
Name:REESER, ELIZABETH BRAY (PT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:BRAY
Last Name:REESER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2308 FURLONG PL
Mailing Address - Street 2:
Mailing Address - City:EASTOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28312-9263
Mailing Address - Country:US
Mailing Address - Phone:910-988-3388
Mailing Address - Fax:910-323-8149
Practice Address - Street 1:2308 FURLONG PL
Practice Address - Street 2:
Practice Address - City:EASTOVER
Practice Address - State:NC
Practice Address - Zip Code:28312-9263
Practice Address - Country:US
Practice Address - Phone:910-988-3388
Practice Address - Fax:910-323-8149
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31612251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics