Provider Demographics
NPI:1952905796
Name:REYNOLDS, SUMMER (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:
Last Name:REYNOLDS
Suffix:
Gender:F
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 1:1350 SAINT LOUIS DR
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1724
Mailing Address - Country:US
Mailing Address - Phone:415-225-0114
Mailing Address - Fax:
Practice Address - Street 1:1441 KAPIOLANI BLVD STE 1113
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4406
Practice Address - Country:US
Practice Address - Phone:415-225-0114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology