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NPI Code Detail

MEDICARE: DR. WESLEY RYAN REYNOLDS DPT

MEDICARE: DR. WESLEY RYAN REYNOLDS DPT
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
1225100000XPhysical Therapist12081NC

General Provider Information

NPI Number : 1982830279
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WESLEY RYAN REYNOLDS DPT
Provider Business Mailing Address
First Line : 101 WALSHINGHAM LN APT LB
Second Line :
City : CARY
State : NC
Zip : 27513-5288
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2702 FARRELL RD
Second Line :
City : SANFORD
State : NC
Zip : 27330-6505
Country : US
Telephone Number : 919-776-9602
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2009
Last Update Date : 06/01/2009

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