Individual
THOMAS REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
400 FAIRVIEW HEIGHTS RD, SUMMERSVILLE, WV 26651-9308
(304) 872-2891
Mailing address
400 FAIRVIEW HEIGHTS RD, SUMMERSVILLE, WV 26651-9308
(304) 872-2891
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
51097
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5710028000
—
WV
Enumeration date
11/16/2005
Last updated
01/13/2010
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