Individual
ELLEN M REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 E IDAHO ST, STE 300, BOISE, ID 83712-6267
(208) 381-7370
(208) 381-7377
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
M-7833
ID
Other
Enumeration date
01/09/2007
Last updated
09/04/2012
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