Individual
MYA REESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
12500 AURORA DR, PLEASANT PRAIRIE, WI 53158-1227
(262) 857-5300
(262) 857-5301
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
(262) 857-5301
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
630112
WI
111N00000X
Chiropractor
CH15393
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100327373
—
WI
Enumeration date
03/03/2025
Last updated
08/18/2025
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