Provider Demographics
NPI:1720408552
Name:REED, GARRY ALAN
Entity Type:Individual
Prefix:
First Name:GARRY
Middle Name:ALAN
Last Name:REED
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 1:231 S 3RD ST STE 130
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-5918
Mailing Address - Country:US
Mailing Address - Phone:702-485-4937
Mailing Address - Fax:702-749-5922
Practice Address - Street 1:231 S 3RD ST STE 130
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-5918
Practice Address - Country:US
Practice Address - Phone:702-485-4937
Practice Address - Fax:702-749-5922
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-19
Last Update Date:2014-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner