MEDICARE: INDIA REID REYNOLDS PT, CWS, MS

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	225100000X	Physical Therapist	P8176	NC

General Provider Information

NPI Number	:	1932479060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INDIA REID REYNOLDS PT, CWS, MS

Provider Business Mailing Address
First Line	:	PO BOX 5105
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-5100
Country	:	US
Telephone Number	:	252-726-1802
Fax Number	:	252-726-1805

Provider Business Practice Location Address
First Line	:	534 N 35TH ST
Second Line	:
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-3182
Country	:	US
Telephone Number	:	252-726-1802
Fax Number	:	252-726-1805

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

Provider Enumeration Date	:	01/05/2012
Last Update Date	:	08/08/2025

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