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General NPI Number Information
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NPI Number | 1194009209
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Entity Type | Individual
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Provider Name | JILL ANN REEVES PT
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Gender | Female
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Dates
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Enumeration Date | 10/07/2011
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Last Update Date | 10/07/2011
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Provider Practice Location Address
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Address Line | 550 E ANN ARBOR AVE
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City | DALLAS
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State | TX
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Zip | 75216-6718
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Country | US
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Telephone | 409-599-6565
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Fax |
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Provider Business Mailing Address
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Address Line | 332 LONGFELLOW AVE
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City | HERMOSA BEACH
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State | CA
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Zip | 90254-2337
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Country | US
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Telephone | 409-599-6565
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1129070
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License Number State | TX
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