Healthcare Provider Details

I. General information

NPI: 1912294232
Provider Name (Legal Business Name): JARED PATRICK REITES DPT, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2011
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1083 PARKWAY BLVD
ATHENS GA
30606-6171
US

IV. Provider business mailing address

1161 COPPERVILLE DR
WATKINSVILLE GA
30677-4136
US

V. Phone/Fax

Practice location:
  • Phone: 706-208-6500
  • Fax:
Mailing address:
  • Phone: 813-323-1820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT012171
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT26462
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: