Individual
MR. JASON DANIEL REEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS,PT
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
PT4077
MS
225100000X
Physical Therapist
Primary
PT4077
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7752862
AETNA
MS
01
—
PT4077
MS BOARD CERTIFICATION #
MS
Enumeration date
08/14/2006
Last updated
03/15/2018
Update your record
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