Provider Demographics
NPI:1518552249
Name:REEL, RICHARD NATHAN
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:NATHAN
Last Name:REEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 ELIZABETH DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452-7057
Mailing Address - Country:US
Mailing Address - Phone:304-269-5220
Mailing Address - Fax:
Practice Address - Street 1:9 TROLLEY ST APT 207
Practice Address - Street 2:
Practice Address - City:JANE LEW
Practice Address - State:WV
Practice Address - Zip Code:26378-8584
Practice Address - Country:US
Practice Address - Phone:304-641-2062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant