Individual
ROGER WAYNE REYNOLDS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NEMT PROVIDER
Contact information
Practice address
14531 DOUGLAS LN, ABINGDON, VA 24210-4827
(276) 477-0997
Mailing address
14531 DOUGLAS LN, ABINGDON, VA 24210-4827
(276) 477-0997
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
T62326452
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T62326452
DRIVERS LICENSE
VA
Enumeration date
05/06/2020
Last updated
05/06/2020
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