Provider Demographics
NPI:1710504212
Name:REYNOLDS, PATRICIA MARIE ORRENCE (DPT)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:MARIE ORRENCE
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:PATRICIA
Other - Middle Name:MARIE
Other - Last Name:ORRENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:8529 NEW CUT RD
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-3304
Mailing Address - Country:US
Mailing Address - Phone:301-980-6004
Mailing Address - Fax:
Practice Address - Street 1:7801 OLD BRANCH AVE STE 105
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-1641
Practice Address - Country:US
Practice Address - Phone:301-856-8386
Practice Address - Fax:301-856-8389
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27953225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist