Provider Demographics
NPI:1497412258
Name:REIS, ISAAC PIUS (DC)
Entity Type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:PIUS
Last Name:REIS
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 1:1221 BLUEGRASS CIR UNIT 11
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-8159
Mailing Address - Country:US
Mailing Address - Phone:319-343-8540
Mailing Address - Fax:
Practice Address - Street 1:1350 BLAIRS FERRY RD STE B
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-1951
Practice Address - Country:US
Practice Address - Phone:319-343-8540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA111139111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor