Provider Demographics
NPI:1952628497
Name:REYNOLDS, MICHELLE 'SHELBY' (CMT)
Entity Type:Individual
Prefix:
First Name:MICHELLE 'SHELBY'
Middle Name:
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 E 8TH ST
Mailing Address - Street 2:SUITE 17
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-2504
Mailing Address - Country:US
Mailing Address - Phone:231-929-8183
Mailing Address - Fax:
Practice Address - Street 1:626 E 8TH ST
Practice Address - Street 2:SUITE 17
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-2504
Practice Address - Country:US
Practice Address - Phone:231-929-8183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist