Individual
BRADEN REEVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
510 LINCOLN DR, HERRIN, IL 62948-6334
(618) 997-6800
Mailing address
510 LINCOLN DR, HERRIN, IL 62948-6334
(618) 997-6800
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
11/26/2019
Last updated
11/26/2019
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