Provider Demographics
NPI:1427879261
Name:REEVES, KODY (LMBT, LMMP)
Entity type:Individual
Prefix:
First Name:KODY
Middle Name:
Last Name:REEVES
Suffix:
Gender:M
Credentials:LMBT, LMMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 FRANKLIN PLZ STE 404
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-3249
Mailing Address - Country:US
Mailing Address - Phone:828-736-2159
Mailing Address - Fax:
Practice Address - Street 1:138 POPLAR GROVE RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-5418
Practice Address - Country:US
Practice Address - Phone:828-634-1807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13350225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist