Provider Demographics
NPI:1578139911
Name:REISER, JOSEPH SCOTT (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:SCOTT
Last Name:REISER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 WIMBISH WAY
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:GA
Mailing Address - Zip Code:31069-9685
Mailing Address - Country:US
Mailing Address - Phone:847-848-3993
Mailing Address - Fax:
Practice Address - Street 1:8 HOSPITAL CENTER BLVD STE 250
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-8702
Practice Address - Country:US
Practice Address - Phone:843-671-7342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT015240225100000X
AZCP008693T225100000X
SC10857225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist