Provider Demographics
NPI:1871616961
Name:REEVE, JOHN PAUL (DC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PAUL
Last Name:REEVE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 SOUTH PEACHTREE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071
Mailing Address - Country:US
Mailing Address - Phone:770-441-2225
Mailing Address - Fax:770-242-7686
Practice Address - Street 1:950 SOUTH PEACHTREE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071
Practice Address - Country:US
Practice Address - Phone:770-441-2225
Practice Address - Fax:770-242-7686
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001665111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T98077Medicare UPIN