Provider Demographics
NPI:1770011041
Name:REEVES, MICHAEL ROSS (DPT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ROSS
Last Name:REEVES
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:560 N ROUTE 100
Mailing Address - Street 2:
Mailing Address - City:BECHTELSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19505-9228
Mailing Address - Country:US
Mailing Address - Phone:610-933-3371
Mailing Address - Fax:610-933-3376
Practice Address - Street 1:131 NUTT RD
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-3905
Practice Address - Country:US
Practice Address - Phone:610-933-3371
Practice Address - Fax:610-933-3376
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9393225100000X
OK5491225100000X
PART0056722255A2300X
PAPT025999225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer