Individual
MITCHELL REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
550 CLUB LN, CONWAY, AR 72034-3681
(501) 327-2495
(205) 683-2468
Mailing address
550 CLUB LN, CONWAY, AR 72034-3681
(501) 327-2495
(205) 683-2468
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR2742
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTR2742
LICENSE
AR
Enumeration date
04/14/2016
Last updated
04/14/2016
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