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General NPI Number Information
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NPI Number | 1053123125
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Entity Type | Individual
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Provider Name | LARESA NICHOLE REED DC
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Gender | Female
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 9957 MOORINGS DRIVE SUITE 305
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City | JACKSONVILLE
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State | FL
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Zip | 32257
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Country | US
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Telephone | 904-600-9347
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Fax |
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Provider Business Mailing Address
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Address Line | 9957 MOORINGS DRIVE SUITE 305
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City | JACKSONVILLE
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State | FL
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Zip | 32257
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Country | US
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Telephone | 904-352-4828
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH13357
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License Number State | FL
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