Provider Demographics
NPI:1013174978
Name:REESE, GERALDINE
Entity Type:Individual
Prefix:MRS
First Name:GERALDINE
Middle Name:
Last Name:REESE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 EDGEHILL CIR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-2232
Mailing Address - Country:US
Mailing Address - Phone:330-491-9848
Mailing Address - Fax:330-491-9848
Practice Address - Street 1:3700 EDGEHILL CIR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-2232
Practice Address - Country:US
Practice Address - Phone:330-491-9848
Practice Address - Fax:330-491-9848
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging