Individual
TERRY REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
7 12TH AVE NW, ARAB, AL 35016-1977
(256) 586-4171
Mailing address
PO BOX 207243, DALLAS, TX 75320-7243
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S437-TA119
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000059586
—
AL
01
—
1427058262
MEDICARE NPI
AL
Enumeration date
07/22/2005
Last updated
02/21/2022
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