Provider Demographics
NPI:1043694631
Name:REESE, JUSTIN (DNM, DTN, PHD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:
Last Name:REESE
Suffix:
Gender:M
Credentials:DNM, DTN, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 LOWER FAYETTEVILLE RD STE A
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-5768
Mailing Address - Country:US
Mailing Address - Phone:770-755-6525
Mailing Address - Fax:
Practice Address - Street 1:802 LOWER FAYETTEVILLE RD STE A
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-5768
Practice Address - Country:US
Practice Address - Phone:770-755-6525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath