Individual provider · Type 1 NPI

Justin C. Reavley

Student in an Organized Health Care Education/Training Program · Edwardsville, IL

NPI number 1295506491 Active

Practice location

6 Hairpin Dr
Edwardsville, IL 62026-1000

Call (618) 650-5688 Map

Mailing address

6 Hairpin Dr., Campus Box 1066
Edwardsville, IL 62026-1000

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1295506491

Justin C. Reavley's National Provider Identifier is 1295506491, issued on Jan 16, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Edwardsville, IL. The record was last updated on Jan 16, 2024.