Individual
SAMUEL L. REYNOLDS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1665 WESLEYAN DR APT 113, MACON, GA 31210-0801
(478) 521-2152
Mailing address
1665 WESLEYAN DR APT 113, MACON, GA 31210-0801
(478) 521-2152
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
04/13/2022
Last updated
04/13/2022
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