Provider Demographics
NPI:1780650556
Name:REESE, KAREN LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LYNN
Last Name:REESE
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 1:735 ARLINGTON AVE N STE 203
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3654
Mailing Address - Country:US
Mailing Address - Phone:727-821-7400
Mailing Address - Fax:727-821-5981
Practice Address - Street 1:735 ARLINGTON AVE N STE 203
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3654
Practice Address - Country:US
Practice Address - Phone:727-821-7400
Practice Address - Fax:727-821-5981
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8255111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381779900Medicaid
FLU0435ZMedicare ID - Type Unspecified