Individual
JONATHAN REIDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27103
(336) 408-2776
Mailing address
30 RICHARDSON PL, AGAWAM, MA 01001-3438
(413) 237-8926
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/28/2016
Last updated
06/29/2018
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