Provider Demographics
NPI:1821199142
Name:REICHARDT, CHRISTINA KAY (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:KAY
Last Name:REICHARDT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 N BUNKER HILL DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85748-3332
Mailing Address - Country:US
Mailing Address - Phone:520-661-1257
Mailing Address - Fax:
Practice Address - Street 1:4540 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2617
Practice Address - Country:US
Practice Address - Phone:520-323-0022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1465152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist