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Individual

ERNEST REAGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5408 DISCOVERY PARK BLVD STE 200, WILLIAMSBURG, VA 23188-2893
(757) 220-8552
(757) 220-0162
Mailing address
8862 PINEY BRANCH LN, PROVIDENCE FORGE, VA 23140-3318
(804) 683-2580

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104001491
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0104001491
LICENSE NUMBER
VA
Enumeration date
03/28/2012
Last updated
03/28/2012
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