Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 4578 | CO |
NPI | 1457301376 |
---|---|
Provider Name | Dr. Craig W. Reeves |
First Address | Colorado Springs, CO 80906-4541 |
Second Address | Colorado Springs, CO 80906-4541 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 08/07/2007 |