Provider Demographics
NPI:1699213462
Name:REEVES, KATIE LEIGH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:LEIGH
Last Name:REEVES
Suffix:
Gender:F
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 1:2041 E SHILOH RD
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-3726
Mailing Address - Country:US
Mailing Address - Phone:662-395-0080
Mailing Address - Fax:662-396-0088
Practice Address - Street 1:2041 E SHILOH RD
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-3726
Practice Address - Country:US
Practice Address - Phone:662-395-0080
Practice Address - Fax:662-396-0088
Is Sole Proprietor?:No
Enumeration Date:2017-02-01
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT3195225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist