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General NPI Number Information
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NPI Number | 1689483489
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Entity Type | Individual
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Provider Name | NICHOLAS REYES DC
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Gender | Male
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 6110 MCFARLAND STATION DR UNIT 301
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City | ALPHARETTA
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State | GA
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Zip | 30004-6806
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Country | US
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Telephone | 470-839-8686
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Fax |
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Provider Business Mailing Address
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Address Line | 6110 MCFARLAND STATION DR UNIT 301
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City | ALPHARETTA
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State | GA
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Zip | 30004-6806
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Country | US
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Telephone | 470-839-8686
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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 | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | CHIRO011313
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License Number State | GA
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