Provider Demographics
NPI:1942896998
Name:REEVES, JOSHUA DANIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:DANIEL
Last Name:REEVES
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 1:691 BOB GLEN CIR
Mailing Address - Street 2:
Mailing Address - City:CENTERTON
Mailing Address - State:AR
Mailing Address - Zip Code:72719-4013
Mailing Address - Country:US
Mailing Address - Phone:901-356-4092
Mailing Address - Fax:
Practice Address - Street 1:572 E CENTERTON BLVD
Practice Address - Street 2:
Practice Address - City:CENTERTON
Practice Address - State:AR
Practice Address - Zip Code:72719-6072
Practice Address - Country:US
Practice Address - Phone:901-356-4092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR16255111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor