| NPI | 1942671730 |
|---|---|
| Former Name | COURTNEY LAYNE REYNOLDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AR PA-642) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: LA 312218) |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2024-01-31 |