Individual
DR. ALEXANDER LAWRENCE REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3399 E LOUISE DR STE 100, MERIDIAN, ID 83642-5212
(208) 887-6813
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
O-1760
ID
207Q00000X
Family Medicine Physician
Primary
O-1760
ID
Other
Enumeration date
04/07/2011
Last updated
04/13/2023
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