Individual
JEFFREY CARROL REAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
23001 DEL LAGO DR, LAGUNA HILLS, CA 92653-1354
(949) 387-7333
Mailing address
24139 HIBISCUS LN, LAKE ELSINORE, CA 92532-2716
(731) 420-3969
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
52945
CA
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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