Provider Demographics
NPI:1467562744
Name:REYNA, MARINES (DC)
Entity Type:Individual
Prefix:DR
First Name:MARINES
Middle Name:
Last Name:REYNA
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 1:275 AVE WINSTON CHURCHILL
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6604
Mailing Address - Country:US
Mailing Address - Phone:939-475-9528
Mailing Address - Fax:
Practice Address - Street 1:1761 CARR. 8838 ER PISO
Practice Address - Street 2:BO. MONACILLOS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:939-475-9528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR417111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor