Individual
KIMBERLY H REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
304 E 6TH AVE, ROME, GA 30161-6000
(706) 378-9044
(706) 378-9046
Mailing address
304 E 6TH AVE, ROME, GA 30161-6000
(706) 378-9044
(706) 378-9046
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT005710
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10047139
—
GA
05
—
340982
—
GA
01
—
52668972
BLUE CROSS BLUE SHIELD
GA
Enumeration date
01/15/2007
Last updated
07/09/2007
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