Provider Demographics
NPI:1124451109
Name:REYNOLDS, BREE ANN
Entity type:Individual
Prefix:
First Name:BREE
Middle Name:ANN
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 DOTY ST
Mailing Address - Street 2:
Mailing Address - City:MINERAL POINT
Mailing Address - State:WI
Mailing Address - Zip Code:53565-1224
Mailing Address - Country:US
Mailing Address - Phone:608-574-7201
Mailing Address - Fax:
Practice Address - Street 1:406 DOTY ST
Practice Address - Street 2:
Practice Address - City:MINERAL POINT
Practice Address - State:WI
Practice Address - Zip Code:53565-1224
Practice Address - Country:US
Practice Address - Phone:608-574-7201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography