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General NPI Number Information
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NPI Number | 1821960808
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Entity Type | Individual
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Provider Name | PAULINE JOI TIU REYES PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/19/2025
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 260 HOSPITAL DR
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City | SOUTH WILLIAMSON
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State | KY
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Zip | 41503-4072
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Country | US
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Telephone | 606-237-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 325 ATKINSON ST
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City | SHENANDOAH JUNCTION
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State | WV
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Zip | 25442-4859
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Country | US
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Telephone |
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 004903
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License Number State | WV
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