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General NPI Number Information
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NPI Number | 1073514709
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Entity Type | Individual
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Provider Name | KEVIN M REID DO
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Gender | Male
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Dates
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Enumeration Date | 08/03/2005
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Last Update Date | 12/10/2013
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Provider Practice Location Address
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Address Line | 425 W GRAND AVE SUITE 2001
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City | DAYTON
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State | OH
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Zip | 45405-4775
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Country | US
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Telephone | 937-226-7887
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Fax | 937-224-5098
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Provider Business Mailing Address
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Address Line | 425 W GRAND AVE SUITE 2001
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City | DAYTON
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State | OH
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Zip | 45405-4775
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Country | US
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Telephone | 937-226-7887
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Fax | 937-224-5098
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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 | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 34002459R
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License Number State | OH
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