Individual
CHARLES LEE REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED, ATC, LAT
Contact information
Practice address
434 E LOOP 281, STE. 103, LONGVIEW, TX 75605-7932
(903) 247-3422
(903) 247-3424
Mailing address
1402 ROSEDOWN ST, LONGVIEW, TX 75604-3636
(903) 297-7150
(903) 247-3424
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATO539
TX
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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