Individual
HERBERT ALLEN REYNOLDS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTA
Contact information
Practice address
103 TEXAS AVE, BANGOR, ME 04401-4324
(207) 947-4557
Mailing address
19 MEMORIAL DR, WINTERPORT, ME 04496-3447
(207) 249-5293
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OA1810
ME
224Z00000X
Occupational Therapy Assistant
—
—
Other
Enumeration date
10/20/2023
Last updated
10/20/2023
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