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General NPI Number Information
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NPI Number | 1255487971
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Entity Type | Organization
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Legal Business Name | REEVE CHIROPRACTIC CLINIC, P.A.
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 09/09/2011
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Provider Practice Location Address
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Address Line | 308 4TH AVE NW
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City | AUSTIN
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State | MN
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Zip | 55912-3140
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Country | US
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Telephone | 507-437-3655
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Fax | 507-433-1613
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Provider Business Mailing Address
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Address Line | 308 4TH AVE NW
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City | AUSTIN
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State | MN
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Zip | 55912-3140
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Country | US
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Telephone | 507-437-3655
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Fax | 507-433-1613
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK OWEN REEVE
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Credential | D.C.
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Telephone | 507-437-3655
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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 | 4613
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1590
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License Number State | MN
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