Individual
MR. REESE MERRITT WITHERS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
250 BON AIR RD, GREENBRAE, CA 94904-1702
(415) 473-6830
Mailing address
250 BON AIR RD, GREENBRAE, CA 94904-1702
(415) 473-6830
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
95089282
CA
163WM0705X
Medical-Surgical Registered Nurse
95089282
CA
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95089282
CA
Other
Enumeration date
01/14/2020
Last updated
02/14/2023
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