Provider Demographics
NPI:1497099311
Name:REED, MARSHALL ANTHONY (DC BS)
Entity Type:Individual
Prefix:
First Name:MARSHALL
Middle Name:ANTHONY
Last Name:REED
Suffix:
Gender:M
Credentials:DC BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 W CHEROKEE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-2103
Mailing Address - Country:US
Mailing Address - Phone:417-438-8035
Mailing Address - Fax:
Practice Address - Street 1:4560 S CAMPBELL AVE
Practice Address - Street 2:SUITE L-112
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65810-1720
Practice Address - Country:US
Practice Address - Phone:417-438-8035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012032772111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor