Individual
JAMANIC JABRE REAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
182 RILEY AVE STE B, MACON, GA 31204-0771
(478) 357-2122
Mailing address
182 RILEY AVE STE B, MACON, GA 31204-0771
(478) 444-9204
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
251J00000X
NURSING
GA
Enumeration date
09/29/2020
Last updated
12/26/2020
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