Provider Demographics
NPI:1154399525
Name:REEVES, ROCKY
Entity type:Individual
Prefix:DR
First Name:ROCKY
Middle Name:
Last Name:REEVES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 PAINE ST SE
Mailing Address - Street 2:STE C
Mailing Address - City:BONDURANT
Mailing Address - State:IA
Mailing Address - Zip Code:50035-1154
Mailing Address - Country:US
Mailing Address - Phone:641-752-1010
Mailing Address - Fax:
Practice Address - Street 1:105 WESTWOOD DR
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-5153
Practice Address - Country:US
Practice Address - Phone:641-752-1010
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-10
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06761111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI16589Medicare ID - Type Unspecified