Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC 4017 | CO |
NPI | 1194842633 |
---|---|
Provider Name | Dr. Richard Earl Reason II |
First Address | Woodland Park, CO 80863-9733 |
Second Address | Woodland Park, CO 80863-9733 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2007 |
Last Update Date | 08/07/2007 |