Provider Demographics
NPI:1598045544
Name:NATHANIEL A REESE DC PC
Entity Type:Organization
Organization Name:NATHANIEL A REESE DC PC
Other - Org Name:LIFE IN MOTION CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:DC, PC
Authorized Official - Phone:724-745-1533
Mailing Address - Street 1:113 CAVASINA DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-1784
Mailing Address - Country:US
Mailing Address - Phone:724-745-1533
Mailing Address - Fax:724-745-3380
Practice Address - Street 1:113 CAVASINA DR
Practice Address - Street 2:SUITE 600
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-1784
Practice Address - Country:US
Practice Address - Phone:724-745-1533
Practice Address - Fax:724-745-3380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-23
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010323111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty