Provider Demographics
NPI:1538232079
Name:REYNOLDS, MARIA VICTORIA
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:VICTORIA
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 1:2608 S QUITMAN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-5724
Mailing Address - Country:US
Mailing Address - Phone:303-934-9265
Mailing Address - Fax:
Practice Address - Street 1:2608 S QUITMAN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-5724
Practice Address - Country:US
Practice Address - Phone:303-934-9265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier