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Individual

KEVIN M REID

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
425 W GRAND AVE, SUITE 2001, DAYTON, OH 45405-4775
(937) 226-7887
(937) 224-5098
Mailing address
425 W GRAND AVE, SUITE 2001, DAYTON, OH 45405-4775
(937) 226-7887
(937) 224-5098

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
34002459R
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000008389
ANTHEM BLUE SHIELD
OH
05
0396076
OH
Enumeration date
08/03/2005
Last updated
12/10/2013
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