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NPI 1245326990

NPI 1245326990 : PATRICK GERALD REED D.C. : BUNNELL, FL

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General NPI Number Information
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    NPI Number           |    1245326990
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    Entity Type          |    Individual 
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    Provider Name        |    PATRICK GERALD REED D.C.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/04/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    4601 EAST HIGHWAY 100 SUITE G4
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    City                 |    BUNNELL
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    State                |    FL
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    Zip                  |    32110
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    Country              |    US
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    Telephone            |    386-437-9990
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    Fax                  |    386-437-9990
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1214 
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    City                 |    BUNNELL
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    State                |    FL
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    Zip                  |    32110-1214
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    Country              |    US
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    Telephone            |    386-437-9990
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    Fax                  |    386-437-9990
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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       |    CH8254
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    License Number State |    FL
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