Provider Demographics
NPI:1881328920
Name:REEDER, LYNNMARIE (PT)
Entity type:Individual
Prefix:
First Name:LYNNMARIE
Middle Name:
Last Name:REEDER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 CAPTIVA XING
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-8621
Mailing Address - Country:US
Mailing Address - Phone:585-314-9404
Mailing Address - Fax:
Practice Address - Street 1:14 CAPTIVA XING
Practice Address - Street 2:
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-8621
Practice Address - Country:US
Practice Address - Phone:585-314-9404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-14
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009464-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist