Provider Demographics
NPI:1699191692
Name:REIS, MARIA (DC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:REIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 E MILLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-1246
Mailing Address - Country:US
Mailing Address - Phone:330-345-0444
Mailing Address - Fax:330-345-9335
Practice Address - Street 1:242 E MILLTOWN RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-1246
Practice Address - Country:US
Practice Address - Phone:330-345-0444
Practice Address - Fax:330-345-9335
Is Sole Proprietor?:No
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4277111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor