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Individual

MR. JOHN MARTIN REYNOLDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW

Contact information

Practice address
205 S MELDRUM ST, FT COLLINS, CO 80521-2071
(970) 484-3494
Mailing address
205 S MELDRUM ST, PO BOX 343, FT COLLINS, CO 80521-2071
(970) 484-3494

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
083
WY
1041C0700X
Clinical Social Worker
Primary
989313
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
304151
BLUE SHIELD NUMBER
WY
Enumeration date
07/07/2005
Last updated
04/17/2008
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