Individual
DAVID J REIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
US HWY 64 OLD HIGH SCHOOL ROAD, SHIPROCK, NM 87420
(505) 368-5163
(505) 368-5502
Mailing address
31277 CR L, MANCOS, CO 81328
(505) 649-2045
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1762
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18721362
—
NM
Enumeration date
12/11/2006
Last updated
07/08/2007
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