MEDICARE: DAVID REECE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA73340	FL

General Provider Information

NPI Number	:	1790190197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID REECE

Provider Business Mailing Address
First Line	:	208 S 4TH AVE
Second Line	:
City	:	WAUCHULA
State	:	FL
Zip	:	33873-2943
Country	:	US
Telephone Number	:	813-401-2554
Fax Number	:

Provider Business Practice Location Address
First Line	:	943 MALL RING RD
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33870-8515
Country	:	US
Telephone Number	:	863-402-2208
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2014
Last Update Date	:	06/24/2014

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