Provider Demographics
NPI:1649963851
Name:ROWLAND, REID JEFFREY
Entity type:Individual
Prefix:
First Name:REID
Middle Name:JEFFREY
Last Name:ROWLAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 E LYNCHBURG SALEM TPKE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-3446
Mailing Address - Country:US
Mailing Address - Phone:540-586-6591
Mailing Address - Fax:540-586-6954
Practice Address - Street 1:1126 E LYNCHBURG SALEM TPKE
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-3446
Practice Address - Country:US
Practice Address - Phone:540-586-6591
Practice Address - Fax:540-586-6954
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1101001040156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician