Provider Demographics
NPI:1588761472
Name:REED, DAVID THOMAS (DC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:THOMAS
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 1:250 W BASELINE RD
Mailing Address - Street 2:#107
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283
Mailing Address - Country:US
Mailing Address - Phone:480-785-1355
Mailing Address - Fax:480-222-0453
Practice Address - Street 1:250 W BASELINE RD
Practice Address - Street 2:#107
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283
Practice Address - Country:US
Practice Address - Phone:480-785-1355
Practice Address - Fax:480-222-0453
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7036111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0931650OtherBLUE CROSS BLUE SHIELDS
AZAZ0931650OtherBLUE CROSS BLUE SHIELDS