Provider Demographics
NPI:1215006630
Name:REEVES, JO J (DC)
Entity Type:Individual
Prefix:
First Name:JO
Middle Name:J
Last Name:REEVES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 S DILLARD ST
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-3914
Mailing Address - Country:US
Mailing Address - Phone:407-656-0390
Mailing Address - Fax:407-656-3395
Practice Address - Street 1:1080 S DILLARD ST
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3914
Practice Address - Country:US
Practice Address - Phone:407-656-0390
Practice Address - Fax:407-656-3395
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4807111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70674Medicare ID - Type Unspecified
FLT84505Medicare UPIN