Individual
JOAN REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
27 FRANKLIN ST, SPRINGVILLE, NY 14141-1314
(716) 592-7400
Mailing address
27 FRANKLIN ST, SPRINGVILLE, NY 14141-1314
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
010878-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02751908
—
NY
Enumeration date
10/19/2006
Last updated
07/08/2007
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