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General NPI Number Information
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NPI Number | 1184538654
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Entity Type | Individual
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Provider Name | ROBERT-EVAN T REEDY
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Gender | Male
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Dates
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Enumeration Date | 09/30/2026
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 405 HARRISON ST
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City | GRATIS
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State | OH
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Zip | 45330-4528
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Country | US
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Telephone | 937-831-4937
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Fax |
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Provider Business Mailing Address
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Address Line | 4501 CAMDEN WEST ELKTON RD
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City | SOMERVILLE
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State | OH
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Zip | 45064-9450
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Country | US
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Telephone | 513-773-1219
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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 | 146M00000X
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Taxonomy Name | Intermediate Emergency Medical Technician
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License Number | 160175
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License Number State | OH
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