MEDICARE: REYNOLDS CHIROPRACTIC INC

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	CHIR005937	GA

General Provider Information

NPI Number	:	1336477983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REYNOLDS CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	3091 MAPLE DR NE STE 208
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-2612
Country	:	US
Telephone Number	:	404-477-1797
Fax Number	:

Provider Business Practice Location Address
First Line	:	3091 MAPLE DR NE STE 208
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-2612
Country	:	US
Telephone Number	:	404-477-1797
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALESIA REYNOLDS
Credential	:	DC
Telephone Number	:	404-477-1797

Provider Enumeration Date	:	11/19/2009
Last Update Date	:	11/19/2009

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