Jessica Reynolds
Individual provider Active NPI Physical Therapy Assistant · Marion, MS
NPI 1891083259 · NPPES record last updated Jul 19, 2011
Key facts
- NPI
- 1891083259
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 4791 (MS)
- Practice address
- 6434 Dale Dr
Marion, MS 39342-8704 - Phone
- (601) 483-4285
- NPI assigned
- Jul 19, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4791 | MS | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 4791 | MS | Yes |
Addresses
Primary practice location
6434 Dale Dr
Marion, MS 39342-8704
Mailing address
4109 Highway 98 W
Summit, MS 39666-9132
Other providers in Marion, MS
- Elizabeth McKenzie
- Tanika Renae Mitchell
- Ole Town Family Pharmacy LLC
- Tiara Person
- Premier Integrated Health Services, PLLC
- Daphne Richmond
- Tarrah Rose
- Kimberly Sessions
- Christy Shelton
- Arthur N. Taylor
All providers in Marion, MS · Physical Therapy Assistant in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.