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Individual

DR. JACOB REYNOLDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
1695 MARIETTA BLVD NW, ATLANTA, GA 30318-3644
(404) 382-8702
Mailing address
1695 MARIETTA BOULEVARD NW, ATLANTA, GA 30318
(404) 382-8702

Taxonomy

Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
PT012532
GA
2251X0800X
Orthopedic Physical Therapist
Primary
PT012532
GA

Other

Enumeration date
08/05/2016
Last updated
08/05/2016
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