MEDICARE: KISCHA SEDONNA REED PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1548208887	OTHER		TRICARE
2	1548208887	OTHER	GA	BCBS

General Provider Information

NPI Number	:	1548208887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KISCHA SEDONNA REED PT

Provider Business Mailing Address
First Line	:	2616 WARM SPRINGS RD
Second Line	:	SUITE B
City	:	COLUMBUS
State	:	GA
Zip	:	31904-5323
Country	:	US
Telephone Number	:	706-243-0016
Fax Number	:	706-243-0019

Provider Business Practice Location Address
First Line	:	2616 WARM SPRINGS RD
Second Line	:	SUITE B
City	:	COLUMBUS
State	:	GA
Zip	:	31904-5323
Country	:	US
Telephone Number	:	706-243-0016
Fax Number	:	706-243-0019

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	02/05/2009

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Directions to “ KISCHA SEDONNA REED PT” Practice Location

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