Provider Demographics
NPI:1770631210
Name:REESE, KIMBERLY H (DC)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:H
Last Name:REESE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 MIDLAND TRL
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-1711
Mailing Address - Country:US
Mailing Address - Phone:502-633-1073
Mailing Address - Fax:502-633-4424
Practice Address - Street 1:1713 MIDLAND TRL
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-1711
Practice Address - Country:US
Practice Address - Phone:502-633-1073
Practice Address - Fax:502-633-4424
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4856111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor