=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467667881
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REED PHYSICAL THERAPY, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/10/2007
-----------------------------------------------------
Last Update Date | 09/11/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2230 WOODBURY PIKE STE 1
-----------------------------------------------------
City | LOYSBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16659
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-766-2295
-----------------------------------------------------
Fax | 814-766-2642
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2230 WOODBURY PIKE STE 1
-----------------------------------------------------
City | LOYSBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16659
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-766-2295
-----------------------------------------------------
Fax | 814-766-2642
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JAY BRADLEY REED SR.
-----------------------------------------------------
Credential | PT DPT OCS CSCS
-----------------------------------------------------
Telephone | 814-766-2295
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number | PT015097 DAPT000200
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------