Individual
MR. JERRY A REAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CERT. HAIR LOSS SPC.
Contact information
Practice address
46227 TIMBERMINE LN, TEMECULA, CA 92592-4131
(609) 608-8086
Mailing address
46227 TIMBERMINE LN, TEMECULA, CA 92592-4131
(609) 608-8086
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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