Provider Demographics
NPI:1588972822
Name:REEVES, JANET R (LMT, NCTMB)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:R
Last Name:REEVES
Suffix:
Gender:F
Credentials:LMT, NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 BLUE AND PURPLE CT
Mailing Address - Street 2:UNIT 1199
Mailing Address - City:ATHENS
Mailing Address - State:NY
Mailing Address - Zip Code:12015
Mailing Address - Country:US
Mailing Address - Phone:518-409-0058
Mailing Address - Fax:
Practice Address - Street 1:49 BLUE AND PURPLE CT
Practice Address - Street 2:UNIT 1199
Practice Address - City:ATHENS
Practice Address - State:NY
Practice Address - Zip Code:12015-3209
Practice Address - Country:US
Practice Address - Phone:518-409-0058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017429-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist