Doctor Name: | MRS. SELENTHIA REEVES |
NPI Number: | 1477782241 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 503 S Main St Suite D Belen, NM - 870023555 |
Business Phone Number: | 5058645927 |
Business Fax Number: | 5058615904 |
Mailing Address: | Po Box 1434, BELEN |
State: | NM |
Postal Code: | 870021434 |
Phone Number: | 5058645927 |
Fax Number: | 5058615904 |
NPI Enumeration Date: | 07/14/2009 |
NPI Last Update Date: | 07/14/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |