Provider Demographics
NPI:1962044974
Name:REEVES, RYAN ROBERT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:ROBERT
Last Name:REEVES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 DOWLING ST STE P
Mailing Address - Street 2:
Mailing Address - City:KENDALLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46755-9436
Mailing Address - Country:US
Mailing Address - Phone:260-582-2151
Mailing Address - Fax:260-544-3369
Practice Address - Street 1:1930 DOWLING ST STE P
Practice Address - Street 2:
Practice Address - City:KENDALLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46755-9436
Practice Address - Country:US
Practice Address - Phone:260-582-2151
Practice Address - Fax:260-544-3369
Is Sole Proprietor?:No
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26023800A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist