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General NPI Number Information
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NPI Number | 1770959165
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Entity Type | Organization
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Legal Business Name | REESE CHIROPRACTIC SPINE BY DESIGN
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Dates
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Enumeration Date | 08/19/2015
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Last Update Date | 08/19/2015
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Provider Practice Location Address
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Address Line | 4603 FM 1463 RD STE 400
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City | KATY
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State | TX
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Zip | 77494-6545
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Country | US
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Telephone | 832-913-8970
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Fax |
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Provider Business Mailing Address
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Address Line | 4603 FM 1463 RD STE 400
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City | KATY
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State | TX
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Zip | 77494-6545
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Country | US
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Telephone | 832-913-8970
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. SANDRA WENTZEL HULS
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Credential | DC, RN, RD
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Telephone | 740-296-9347
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 12408
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License Number State | TX
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