Provider Demographics
NPI:1710430426
Name:REYNOLDS, DAVID RAYMOND (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RAYMOND
Last Name:REYNOLDS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1632
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24068-1632
Mailing Address - Country:US
Mailing Address - Phone:540-585-4841
Mailing Address - Fax:540-585-4842
Practice Address - Street 1:227 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-6093
Practice Address - Country:US
Practice Address - Phone:540-585-4841
Practice Address - Fax:540-585-4842
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305210488225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist