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Individual

MRS. LAURA B. REAGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
601 W MAIN ST STE B, BYRDSTOWN, TN 38549-2418
(931) 864-8090
(931) 864-8091
Mailing address
PO BOX 368, BYRDSTOWN, TN 38549-0368
(931) 864-8090
(931) 864-8091

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000006366
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1213804
CHA
TN
05
3659342
TN
01
4084962
BCBS
TN
01
522444470
CENTER CARE
TN
01
6366
BLUEGRASS FAMILY HEALTH
TN
01
9358258
PHCS
TN
01
P00138386
RAILROAD MEDICARE
TN
Enumeration date
12/29/2005
Last updated
07/20/2021
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