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NICHOLAS JOSEPH REIST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
560 S LOOP RD, EDGEWOOD, KY 41017-3405
(859) 301-2663
(859) 817-7848
Mailing address
560 S LOOP RD, EDGEWOOD, KY 41017-3405
(859) 301-2663
(859) 817-7848

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50 004628RX
OH
363A00000X
Physician Assistant
Primary
PA2424
KY
363A00000X
Physician Assistant
TC752
KY

Other

Enumeration date
12/18/2015
Last updated
10/26/2021
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