Organization
REEVE CHIROPRACTIC CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK OWEN REEVE D.C. (OWNER)
(507) 437-3655
Entity
Organization
Contact information
Practice address
308 4TH AVE NW, AUSTIN, MN 55912-3140
(507) 437-3655
(507) 433-1613
Mailing address
308 4TH AVE NW, AUSTIN, MN 55912-3140
(507) 437-3655
(507) 433-1613
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1590
MN
111N00000X
Chiropractor
4613
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078882100
—
MN
01
—
1590
MN LICENSE NUMBER
MN
01
—
32331RE
BCBS GROUP NUMBER
MN
01
—
4613
MN LICENSE NUMBER
MN
Enumeration date
01/26/2007
Last updated
09/09/2011
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