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General NPI Number Information
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NPI Number | 1730288564
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Entity Type | Individual
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Provider Name | JOEL GREG MCREYNOLDS PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 07/14/2014
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Provider Practice Location Address
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Address Line | 2810 W 35TH ST
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City | KEARNEY
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State | NE
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Zip | 68845-2909
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Country | US
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Telephone | 308-865-2570
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Fax | 308-865-2508
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Provider Business Mailing Address
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Address Line | 2810 W 35TH ST
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City | KEARNEY
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State | NE
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Zip | 68845-2909
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Country | US
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Telephone | 308-865-2570
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Fax | 308-865-2508
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 971
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License Number State | NE
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