Provider Demographics
NPI:1922270719
Name:KAREN REYNOLDS ACUPUNCTURE AND ORIENTAL MEDICINE CORPORATION
Entity Type:Organization
Organization Name:KAREN REYNOLDS ACUPUNCTURE AND ORIENTAL MEDICINE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:415-381-8500
Mailing Address - Street 1:600 MILLER AVE
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-2990
Mailing Address - Country:US
Mailing Address - Phone:415-381-8500
Mailing Address - Fax:415-381-8558
Practice Address - Street 1:600 MILLER AVE
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-2990
Practice Address - Country:US
Practice Address - Phone:415-381-8500
Practice Address - Fax:415-381-8558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7821171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty