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NPI Code Detail

MEDICARE: JULIE REYNOLDS PTA

MEDICARE: JULIE REYNOLDS PTA
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
1225200000XPhysical Therapy Assistant3922MA

General Provider Information

NPI Number : 1902925415
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE REYNOLDS PTA
Provider Business Mailing Address
First Line : 132 CONNECTICUT AVE
Second Line :
City : PITTSFIELD
State : MA
Zip : 01201-3614
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1000 NORTH ST
Second Line :
City : PITTSFIELD
State : MA
Zip : 01201-1520
Country : US
Telephone Number : 413-499-7186
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2007
Last Update Date : 07/08/2007

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Directions to “ JULIE REYNOLDS PTA” Practice Location

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