Provider Demographics
NPI:1922731728
Name:REID, KAITLYN ELIZABETH (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:ELIZABETH
Last Name:REID
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 1:6041 BOARD DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:AZ
Mailing Address - Zip Code:85539-8686
Mailing Address - Country:US
Mailing Address - Phone:513-518-1583
Mailing Address - Fax:
Practice Address - Street 1:5880 N HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:GLOBE
Practice Address - State:AZ
Practice Address - Zip Code:85501
Practice Address - Country:US
Practice Address - Phone:928-402-1280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ011699225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty