Healthcare Provider Details

I. General information

NPI: 1164369948
Provider Name (Legal Business Name): KIMBERLY REESE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PROGRESS POINT PKWY STE 100
O FALLON MO
63368-2212
US

IV. Provider business mailing address

7570 WELLINGTON WAY APT 3E
CLAYTON MO
63105-2867
US

V. Phone/Fax

Practice location:
  • Phone: 314-859-0400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: