Provider Demographics
NPI:1093703761
Name:WOODS-REYNOLDS, JANNETTE Y (PT)
Entity Type:Individual
Prefix:MS
First Name:JANNETTE
Middle Name:Y
Last Name:WOODS-REYNOLDS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 DAVIS GROVE CIRCLE SUITE 107
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519
Mailing Address - Country:US
Mailing Address - Phone:919-303-5478
Mailing Address - Fax:919-303-5468
Practice Address - Street 1:202 DAVIS GROVE CIRCLE SUITE 107
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519
Practice Address - Country:US
Practice Address - Phone:919-303-5478
Practice Address - Fax:919-303-5468
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7387225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2506102Medicare ID - Type UnspecifiedPROVIDER NUMBER