Provider Demographics
NPI:1871741942
Name:REESE, GEORGE K (DC)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:K
Last Name:REESE
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 1:2859 EL CAJON BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-1292
Mailing Address - Country:US
Mailing Address - Phone:619-688-0080
Mailing Address - Fax:619-688-9550
Practice Address - Street 1:2859 EL CAJON BLVD STE A
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-1292
Practice Address - Country:US
Practice Address - Phone:619-688-0080
Practice Address - Fax:619-688-9550
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21789111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor