Provider Demographics
NPI:1770634800
Name:REEVES, HERBERT T (PT, MHS)
Entity Type:Individual
Prefix:MR
First Name:HERBERT
Middle Name:T
Last Name:REEVES
Suffix:
Gender:M
Credentials:PT, MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 OSBORNE LN
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-8335
Mailing Address - Country:US
Mailing Address - Phone:803-463-9886
Mailing Address - Fax:
Practice Address - Street 1:128 OSBORNE LN
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-8335
Practice Address - Country:US
Practice Address - Phone:803-463-9886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1927225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist