Provider Demographics
NPI:1134473432
Name:REILLY, CYNTHIA KIRBY (DIPL AC)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:KIRBY
Last Name:REILLY
Suffix:
Gender:F
Credentials:DIPL AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 COLVIN HILL RD
Mailing Address - Street 2:
Mailing Address - City:DANBY
Mailing Address - State:VT
Mailing Address - Zip Code:05739-6600
Mailing Address - Country:US
Mailing Address - Phone:802-293-2065
Mailing Address - Fax:
Practice Address - Street 1:802 MAIN ST
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-2636
Practice Address - Country:US
Practice Address - Phone:802-442-4442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0910000218171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist