Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 11012 | TX |
NPI | 1164700357 |
---|---|
Provider Name | Dr. Jameelah Reid |
First Address | Irving, TX 75060 |
Second Address | Dallas, TX 75240-6401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2011 |
Last Update Date | 22/07/2011 |