Provider Demographics
NPI:1972809424
Name:REYES, RICHARD RONALD (RMT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:RONALD
Last Name:REYES
Suffix:
Gender:M
Credentials:RMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 W. ABRIENDO SUITE B
Mailing Address - Street 2:ABRIENDO ACUPUNCTURE
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81004
Mailing Address - Country:US
Mailing Address - Phone:719-778-1269
Mailing Address - Fax:
Practice Address - Street 1:226 W ABRIENDO AVE
Practice Address - Street 2:SUITE B
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81004-1868
Practice Address - Country:US
Practice Address - Phone:719-778-1269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-01
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9010172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist