Provider Demographics
NPI:1669171880
Name:REER, JOHN PAUL
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PAUL
Last Name:REER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 S BUCKEYE ST
Mailing Address - Street 2:
Mailing Address - City:OSGOOD
Mailing Address - State:IN
Mailing Address - Zip Code:47037-1332
Mailing Address - Country:US
Mailing Address - Phone:812-907-1474
Mailing Address - Fax:
Practice Address - Street 1:820 S BUCKEYE ST
Practice Address - Street 2:
Practice Address - City:OSGOOD
Practice Address - State:IN
Practice Address - Zip Code:47037-1332
Practice Address - Country:US
Practice Address - Phone:812-907-1474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003378A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor