MEDICARE: DR. CRAIG W. REEVES DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NX0800X	Orthopedic Chiropractor	4578	CO

General Provider Information

NPI Number	:	1457301376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRAIG W. REEVES DC

Provider Business Mailing Address
First Line	:	3234 BRECKENRIDGE DR W
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4541
Country	:	US
Telephone Number	:	719-527-0062
Fax Number	:	719-527-0062

Provider Business Practice Location Address
First Line	:	3234 BRECKENRIDGE DR W
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4541
Country	:	US
Telephone Number	:	719-527-0062
Fax Number	:	719-527-0062

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	07/08/2007

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