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General NPI Number Information
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NPI Number | 1447212535
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Entity Type | Organization
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Legal Business Name | REYNOLDS ROAD SURGICAL CENTER LTD
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 04/22/2014
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Provider Practice Location Address
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Address Line | 2865 N REYNOLDS RD SUITE 190
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City | TOLEDO
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State | OH
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Zip | 43615-2068
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Country | US
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Telephone | 419-578-7500
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Fax | 419-539-6320
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Provider Business Mailing Address
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Address Line | 2865 N REYNOLDS RD SUITE 190
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City | TOLEDO
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State | OH
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Zip | 43615-2068
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Country | US
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Telephone | 419-578-7500
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Fax | 419-539-6320
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Authorized Official
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Title or Position | MANAGER OF FINANCE
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Name | KELLY G SHIRER
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Credential | CASC
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Telephone | 419-578-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 0437AS
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License Number State | OH
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