Provider Demographics
NPI:1144282039
Name:REYNOLDS, PAULA GRUENSFELDER (DC)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:GRUENSFELDER
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 MAIN ST E
Mailing Address - Street 2:
Mailing Address - City:VALDESE
Mailing Address - State:NC
Mailing Address - Zip Code:28690-2808
Mailing Address - Country:US
Mailing Address - Phone:828-874-6292
Mailing Address - Fax:828-874-6292
Practice Address - Street 1:138 MAIN ST E
Practice Address - Street 2:
Practice Address - City:VALDESE
Practice Address - State:NC
Practice Address - Zip Code:28690-2808
Practice Address - Country:US
Practice Address - Phone:828-874-6292
Practice Address - Fax:828-874-6292
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1926111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890876KMedicaid
NC0876KOtherBCBS
NC100950OtherACN
NC0876KOtherBCBS