Individual
MS. MICHAELA A REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
5 MILLBROOK RD, SCARBOROUGH, ME 04074-9702
(207) 510-6500
(207) 510-6565
Mailing address
26 COULTHARD FARMS RD, SCARBOROUGH, ME 04074-7506
(207) 510-6500
(207) 510-6565
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1150
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061508
ANTHEM BC/BS
ME
01
—
11507673
CAQH
—
01
—
1173427
AETNA
ME
Enumeration date
10/04/2006
Last updated
03/04/2013
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