Provider Demographics
NPI:1598942450
Name:REESE, DONALD E (DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:E
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 1:2003 CAROLINA BEACH RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7201
Mailing Address - Country:US
Mailing Address - Phone:910-763-3611
Mailing Address - Fax:910-763-3687
Practice Address - Street 1:2003 CAROLINA BEACH ROAD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7201
Practice Address - Country:US
Practice Address - Phone:910-763-3611
Practice Address - Fax:910-763-3687
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1507111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8908752Medicaid
NC8908752Medicaid
NC244479Medicare PIN