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NPI Code Detail

MEDICARE: MR. SETH MICHAEL REYNOLDS BOC-O, CP

MEDICARE: MR. SETH MICHAEL REYNOLDS BOC-O, CP
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
1222Z00000XOrthotistC49811MD
2224P00000XProsthetistNC
3224P00000XProsthetistCP003528DE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CP003528OTHERNCCERTIFIED PROSTHETIST
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3C49811OTHERCERTIFIED ORTHOTIST

General Provider Information

NPI Number : 1396983300
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SETH MICHAEL REYNOLDS BOC-O, CP
Provider Business Mailing Address
First Line : PO BOX 428
Second Line :
City : SKYLAND
State : NC
Zip : 28776-0428
Country : US
Telephone Number : 828-684-1644
Fax Number : 828-684-1104
Provider Business Practice Location Address
First Line : 3845 HENDERSONVILLE RD
Second Line :
City : FLETCHER
State : NC
Zip : 28732-8241
Country : US
Telephone Number : 828-684-1644
Fax Number : 828-684-1104
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2009
Last Update Date : 05/13/2015

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