Provider Demographics
NPI:1114070679
Name:REESE, ROBERT A (DC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:A
Last Name:REESE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:1037 ANNA KNAPP BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3674
Mailing Address - Country:US
Mailing Address - Phone:302-376-5830
Mailing Address - Fax:302-376-5232
Practice Address - Street 1:401 E. MAIN STREET
Practice Address - Street 2:BLDG. 4 SUITE B
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709
Practice Address - Country:US
Practice Address - Phone:302-376-5830
Practice Address - Fax:302-376-5832
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2018-03-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC3631111N00000X
DEF1-0000491111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor