Individual
ROBERT COLBY REYNOLDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
8400 E FLORENTINE RD, PRESCOTT VALLEY, AZ 86314-8653
(928) 775-9999
(928) 775-9998
Mailing address
8400 E FLORENTINE RD, PRESCOTT VALLEY, AZ 86314-8653
(928) 775-9999
(928) 775-9998
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10983
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12778513
CAQH
AZ
05
—
962931
—
AZ
01
—
P01699221
RR MEDICARE
AZ
Enumeration date
06/30/2014
Last updated
02/01/2017
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