MEDICARE: DR. SAVANNAH FAYE REYNOLDS DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	3338	TN
2	111N00000X	Chiropractor	0104557610	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0104-557610	OTHER	VA	LICENSE NUMBER
2	3338	OTHER	TN	LICENSE NUMBER

General Provider Information

NPI Number	:	1245872522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAVANNAH FAYE REYNOLDS DC

Provider Business Mailing Address
First Line	:	944 LICK FRK
Second Line	:
City	:	MILLSTONE
State	:	KY
Zip	:	41838-9063
Country	:	US
Telephone Number	:	423-405-0990
Fax Number	:

Provider Business Practice Location Address
First Line	:	2629 W ANDREW JOHNSON HWY STE 210
Second Line	:
City	:	MORRISTOWN
State	:	TN
Zip	:	37814-3390
Country	:	US
Telephone Number	:	423-405-0990
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2019
Last Update Date	:	03/09/2021

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Directions to “ DR. SAVANNAH FAYE REYNOLDS DC” Practice Location

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