Provider Demographics
NPI:1013096957
Name:REYNOLDS, AMY MELISSA-WELDON (PTA)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MELISSA-WELDON
Last Name:REYNOLDS
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Gender:F
Credentials:PTA
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Mailing Address - Street 1:701 SAVANNAH RD
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1550
Mailing Address - Country:US
Mailing Address - Phone:302-644-2530
Mailing Address - Fax:302-644-2556
Practice Address - Street 1:721 REHOBOTH AVE
Practice Address - Street 2:SUITE 12
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-3169
Practice Address - Country:US
Practice Address - Phone:302-227-2008
Practice Address - Fax:302-227-8098
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DEJ2-0000665225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant