Individual
ANDREA L REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
129 PHELPS AVE, ROCKFORD, IL 61108-2453
(224) 805-0000
Mailing address
129 PHELPS AVE, ROCKFORD, IL 61108-2453
(224) 805-0000
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.005720
IL
Other
Enumeration date
11/01/2009
Last updated
09/08/2015
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