Individual
JACOB REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6170 CENTRAL ST, ROMULUS, MI 48174-4217
(734) 512-9296
Mailing address
6170 CENTRAL ST, ROMULUS, MI 48174-4217
(734) 512-9296
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
MI
Other
Enumeration date
09/12/2016
Last updated
09/12/2016
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