MEDICARE: DR. DAVID B. REYNOLDS D.C.

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	111N00000X	Chiropractor	0104556074	VA

General Provider Information

NPI Number	:	1215086848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID B. REYNOLDS D.C.

Provider Business Mailing Address
First Line	:	6324 FORT HUNT DR
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22307-1343
Country	:	US
Telephone Number	:	703-765-1001
Fax Number	:

Provider Business Practice Location Address
First Line	:	6324 FORT HUNT DR
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22307-1343
Country	:	US
Telephone Number	:	703-765-1001
Fax Number	:

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

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	10/26/2007

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