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Individual
MR. PAUL CHARLES REED
Active
Individual
MR. PAUL CHARLES REED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305207950
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366466864
MEDICAID QMB
VA
01
—
C05954
GROUP MEDICARE PTAN
VA
Enumeration date
07/27/2006
Last updated
04/30/2018
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