Provider Demographics
NPI:1093200255
Name:REYNOLDS, CORTNEY BRIANNA (DPT)
Entity type:Individual
Prefix:
First Name:CORTNEY
Middle Name:BRIANNA
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 PRESERVATION ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-4487
Mailing Address - Country:US
Mailing Address - Phone:937-260-9212
Mailing Address - Fax:
Practice Address - Street 1:4801 SPRINGFIELD ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45431-1084
Practice Address - Country:US
Practice Address - Phone:937-236-9965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT017475225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist