Healthcare Provider Details

I. General information

NPI: 1760985816
Provider Name (Legal Business Name): NICOLE F REED DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE F MATTERA

II. Dates (important events)

Enumeration Date: 03/15/2018
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1393 DUBLIN RD
COLUMBUS OH
43215-1084
US

IV. Provider business mailing address

7710 OLENTANGY RIVER RD STE 100
COLUMBUS OH
43235-1353
US

V. Phone/Fax

Practice location:
  • Phone: 614-487-9715
  • Fax: 614-487-9716
Mailing address:
  • Phone: 614-841-3900
  • Fax: 614-841-3930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT017303
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: