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Individual

MRS. KATHERINE HANCE REYNOLDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
500 IRVINGTON RD, KILMARNOCK, VA 22482-0108
(804) 435-3435
Mailing address
500 IRVINGTON RD, KILMARNOCK, VA 22482-0108
(804) 435-3435

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305205744
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009402331
VA
01
20091
SENTARA
VA
01
250404
BCBS PROVIDER ID
VA
01
541726590
COMMERCIAL/WC CARRIER
VA
Enumeration date
07/31/2009
Last updated
11/16/2009
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