Provider Demographics
NPI:1740330513
Name:REEVES, JEFFREY SCOTT (DC)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:SCOTT
Last Name:REEVES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5350 KEMPSRIVER DR STE 110
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-5370
Mailing Address - Country:US
Mailing Address - Phone:757-424-2626
Mailing Address - Fax:757-366-0129
Practice Address - Street 1:5350 KEMPSRIVER DR STE 110
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-5370
Practice Address - Country:US
Practice Address - Phone:757-424-2626
Practice Address - Fax:757-366-0129
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556507111N00000X
SC2688111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor