Provider Demographics
NPI:1083390769
Name:REEVS, HEATHER (ABOC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:REEVS
Suffix:
Gender:F
Credentials:ABOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 MILLER ST
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17801-2949
Mailing Address - Country:US
Mailing Address - Phone:570-246-9313
Mailing Address - Fax:
Practice Address - Street 1:1070 MILLER ST
Practice Address - Street 2:
Practice Address - City:SUNBURY
Practice Address - State:PA
Practice Address - Zip Code:17801-2949
Practice Address - Country:US
Practice Address - Phone:570-246-9313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician