Individual
MR. DAN DAWAYNE REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R. EEG T. , CNIM
Contact information
Practice address
10207 CHARLES ST, OSCEOLA, IN 46561-8922
(217) 494-4243
(574) 968-6448
Mailing address
460 GODDARD, IRVINE, CA 92618-4610
(217) 494-4243
(949) 336-5113
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
1000
IL
2472E0500X
EEG Technician
3901
IL
2472E0500X
EEG Technician
Primary
—
CA
Other
Enumeration date
01/27/2009
Last updated
11/14/2013
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