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Individual

KELLY L. REYNOLDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S.P.T.

Contact information

Practice address
724 COMMERCIAL ST, ROCKPORT, ME 04856-4201
(207) 596-0374
(207) 596-0375
Mailing address
724 COMMERCIAL ST, ROCKPORT, ME 04856-4201
(207) 596-0374
(207) 596-0375

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2794
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1235215070
ME
Enumeration date
11/28/2006
Last updated
12/30/2010
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