Provider Demographics
NPI:1861035016
Name:BRENT REEVE PLLC
Entity Type:Organization
Organization Name:BRENT REEVE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:REEVE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:616-856-8858
Mailing Address - Street 1:4582 W RIVER DR NE STE F
Mailing Address - Street 2:
Mailing Address - City:COMSTOCK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:49321-8941
Mailing Address - Country:US
Mailing Address - Phone:616-856-8858
Mailing Address - Fax:
Practice Address - Street 1:4582 W RIVER DR NE STE F
Practice Address - Street 2:
Practice Address - City:COMSTOCK PARK
Practice Address - State:MI
Practice Address - Zip Code:49321-8941
Practice Address - Country:US
Practice Address - Phone:616-856-8858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-21
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty