Individual
JACK REAUME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16911 VILLAGE LAKE DR, LINDALE, TX 75771-5065
(903) 882-7055
Mailing address
PO BOX 782, LINDALE, TX 75771-0782
(903) 530-8177
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2042331
TX
Other
Enumeration date
03/25/2020
Last updated
03/25/2020
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