Provider Demographics
NPI:1356364095
Name:REYNOLDS, ERIN L (MSPT)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:L
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:L
Other - Last Name:HARROP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-3108
Mailing Address - Country:US
Mailing Address - Phone:401-884-9541
Mailing Address - Fax:401-884-9509
Practice Address - Street 1:18 5TH AVE
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-3108
Practice Address - Country:US
Practice Address - Phone:401-884-9541
Practice Address - Fax:401-884-9509
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT01694225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI411875OtherRI BLUE CHIP PIN
RI007056952Medicare PIN