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NPI Code Detail

MEDICARE: MS. KELLY G REECE DPT

MEDICARE: MS. KELLY G REECE DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist10043SC
2225100000XPhysical TherapistPT27240FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346516770
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KELLY G REECE DPT
Provider Business Mailing Address
First Line : 24 HOLLYWOOD BLVD SW STE 7
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32548-4893
Country : US
Telephone Number : 850-226-7411
Fax Number : 850-613-6515
Provider Business Practice Location Address
First Line : 130 FORUM DR STE 13
Second Line :
City : COLUMBIA
State : SC
Zip : 29229-7943
Country : US
Telephone Number : 803-509-6880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2012
Last Update Date : 03/12/2020

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Directions to “ MS. KELLY G REECE DPT” Practice Location

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