Provider Demographics
NPI:1437358082
Name:REESE, BYRON PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:BYRON
Middle Name:PAUL
Last Name:REESE
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 1:172 WENONA WAY
Mailing Address - Street 2:
Mailing Address - City:FITZGERALD
Mailing Address - State:GA
Mailing Address - Zip Code:31750-8681
Mailing Address - Country:US
Mailing Address - Phone:229-635-2029
Mailing Address - Fax:
Practice Address - Street 1:172 WENONA WAY
Practice Address - Street 2:
Practice Address - City:FITZGERALD
Practice Address - State:GA
Practice Address - Zip Code:31750-8681
Practice Address - Country:US
Practice Address - Phone:229-635-2029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO08160111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor