Individual
JEFF G REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11 WESTMARK AVE, COLORADO SPRINGS, CO 80906-4738
(719) 660-6826
(719) 218-1010
Mailing address
2540 CARDIGAN DR, COLORADO SPRINGS, CO 80920-5348
(719) 660-6826
(719) 218-1010
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
23U713
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23U713
ASSISTED LIVING
CO
Enumeration date
08/01/2018
Last updated
08/01/2018
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