Provider Demographics
NPI:1982017414
Name:REEVES, KERRI (ATC)
Entity Type:Individual
Prefix:MS
First Name:KERRI
Middle Name:
Last Name:REEVES
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:NAUVOO
Mailing Address - State:AL
Mailing Address - Zip Code:35578-5744
Mailing Address - Country:US
Mailing Address - Phone:205-522-9589
Mailing Address - Fax:334-683-2381
Practice Address - Street 1:1101 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:AL
Practice Address - Zip Code:36756-3208
Practice Address - Country:US
Practice Address - Phone:334-302-1402
Practice Address - Fax:334-683-2381
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12872255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer