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General NPI Number Information
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NPI Number | 1841728359
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Entity Type | Individual
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Provider Name | EMILY ELAINE REYNOLDS OD
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Gender | Female
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Dates
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Enumeration Date | 05/28/2017
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Last Update Date | 10/11/2021
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Provider Practice Location Address
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Address Line | 2013 STATE ROUTE 59
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City | KENT
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State | OH
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Zip | 44240-4113
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Country | US
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Telephone | 330-678-0201
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Fax |
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Provider Business Mailing Address
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Address Line | 6880 W SNOWVILLE RD STE 215
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City | BRECKSVILLE
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State | OH
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Zip | 44141-3254
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Country | US
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Telephone | 440-656-5050
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 006576
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License Number State | OH
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