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General NPI Number Information
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NPI Number | 1194844639
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Entity Type | Organization
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Legal Business Name | REYNOLDS PROSTHETICS & ORTHOTICS, INC.
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1062 OAK RIDGE TPKE STE B
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City | OAK RIDGE
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State | TN
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Zip | 37830-6479
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Country | US
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Telephone | 865-483-8787
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Fax | 865-483-8789
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Provider Business Mailing Address
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Address Line | PO BOX 4729
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City | MARYVILLE
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State | TN
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Zip | 37802-4729
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Country | US
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Telephone | 865-483-8787
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Fax | 865-483-8789
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOHN H REYNOLDS
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Credential | CPO
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Telephone | 865-980-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | TN
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