Reynolds, Terrence J
Reynolds, Terrence J is an sole proprietor health care provider with primary practice located at 6700 W Emerald St , Boise ID 83704-8727. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Reynolds, Terrence J can be contacted via phone (208) 336-7100.Contact Information
Primary practice address
6700 W Emerald St
Boise ID 83704-8727
Phone: (208) 336-7100
Fax: (208) 321-2710
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | ODP-807 | Idaho |
Profile Details
| NPI number | 1386628162 |
|---|---|
| LBN Legal business name | Reynolds, Terrence J |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 5th, 2005 |
| Last updated | Aug 31st, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386628162 | NPPES |
| Idaho | MEDICAID | 002692102 |
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