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Individual

TEDDY CHRISTOPHER REECE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
717 ALAMEDA BLVD, CORONADO, CA 92118-2013
(619) 435-3214
Mailing address
4615 UTAH ST APT 7, SAN DIEGO, CA 92116-3177
(619) 540-8342

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D8574116
DRIVER LICENSE
CA
Enumeration date
02/25/2020
Last updated
02/25/2020
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