Provider Demographics
NPI:1497283808
Name:REESE, ERIKA MARIE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ERIKA
Middle Name:MARIE
Last Name:REESE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:ERIKA
Other - Middle Name:MARIE
Other - Last Name:HEINBAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:400 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-1951
Mailing Address - Country:US
Mailing Address - Phone:218-786-8364
Mailing Address - Fax:
Practice Address - Street 1:407 E 3RD ST
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-1950
Practice Address - Country:US
Practice Address - Phone:218-786-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2022-10-31
Deactivation Date:2019-09-18
Deactivation Code:
Reactivation Date:2021-10-28
Provider Licenses
StateLicense IDTaxonomies
AZ13034PT225100000X
MN12508225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist