Healthcare Provider Details

I. General information

NPI: 1053301176
Provider Name (Legal Business Name): MICHAEL L REEVES D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 W WALLACE ST STE. 7
SAN SABA TX
76877-3928
US

IV. Provider business mailing address

2005 W WALLACE ST STE. 7
SAN SABA TX
76877-3928
US

V. Phone/Fax

Practice location:
  • Phone: 325-372-4062
  • Fax: 325-372-6086
Mailing address:
  • Phone: 325-372-4062
  • Fax: 325-372-6086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8589
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: