Provider Demographics
NPI:1386849461
Name:REED, DAVID B (DC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:REED
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1943 ACACIA PL
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-6757
Mailing Address - Country:US
Mailing Address - Phone:435-674-0026
Mailing Address - Fax:435-628-7843
Practice Address - Street 1:301 E TABERNACLE ST
Practice Address - Street 2:STE. 204
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-7108
Practice Address - Country:US
Practice Address - Phone:435-674-0026
Practice Address - Fax:435-628-7843
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT176025-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT680026213OtherTAX ID NUMBER
UT000056016Medicare PIN