Provider Demographics
NPI:1235489451
Name:JO J REEVES DCPA
Entity Type:Organization
Organization Name:JO J REEVES DCPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JO
Authorized Official - Middle Name:J
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-656-6300
Mailing Address - Street 1:424 N DILLARD ST
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-2817
Mailing Address - Country:US
Mailing Address - Phone:407-656-0390
Mailing Address - Fax:
Practice Address - Street 1:424 N DILLARD ST
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-2817
Practice Address - Country:US
Practice Address - Phone:407-656-0390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-14
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4807111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70674OtherMEDICARE PTAN
FL70674OtherMEDICARE PTAN