Individual
MR. ANTHONY WILLIAM REYNOLDS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SFIDC
Contact information
Practice address
34101 FARENHOLT AVE BLDG 14, SAN DIEGO, CA 92134-7000
(860) 933-9857
Mailing address
34101 FARENHOLT AVE BLDG 14, SAN DIEGO, CA 92134-7000
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
07/05/2018
Last updated
07/05/2018
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