Individual
REEVES MBU ADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2250 HICKORY RD, PLYMOUTH MEETING, PA 19462-1047
(800) 879-4471
Mailing address
3575 FORT MEADE RD, LAUREL, MD 20724-2016
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP45319
MD
Other
Enumeration date
12/17/2008
Last updated
12/17/2008
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