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General NPI Number Information
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NPI Number | 1417161837
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Entity Type | Organization
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Legal Business Name | GARY M REID DCPC
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 03/31/2014
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Provider Practice Location Address
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Address Line | 2009 AERO WAY 101
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City | MEDFORD
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State | OR
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Zip | 97504-9822
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Country | US
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Telephone | 541-770-7471
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Fax | 541-732-1466
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Provider Business Mailing Address
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Address Line | 2009 AERO WAY 101
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City | MEDFORD
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State | OR
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Zip | 97504-9822
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Country | US
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Telephone | 541-770-7471
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Fax | 541-732-1466
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARY M REID
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Credential | DC
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Telephone | 541-770-7471
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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 | 27 3001
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License Number State | OR
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