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NPI Code Detail

MEDICARE: RICK REAGER

MEDICARE:   RICK  REAGER
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1841780202
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICK REAGER
Provider Business Mailing Address
First Line : 1582 N WAGGONER RD
Second Line :
City : BLACKLICK
State : OH
Zip : 43004-8669
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1582 N WAGGONER RD
Second Line :
City : BLACKLICK
State : OH
Zip : 43004-8669
Country : US
Telephone Number : 303-989-8169
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2018
Last Update Date : 04/11/2022

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Directions to “ RICK REAGER ” Practice Location

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