Provider Demographics
NPI:1134258098
Name:REUER, DENNIS M (D C, P T)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:M
Last Name:REUER
Suffix:
Gender:M
Credentials:D C, P T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 E DAILY DR STE 7
Mailing Address - Street 2:P. O. BOX 88
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-5833
Mailing Address - Country:US
Mailing Address - Phone:805-389-3722
Mailing Address - Fax:805-389-3724
Practice Address - Street 1:221 E DAILY DR STE 7
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-5833
Practice Address - Country:US
Practice Address - Phone:805-389-3722
Practice Address - Fax:805-389-3724
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 18198111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor