Doctor Name: | LAURA L REYNOLDS |
NPI Number: | 1194996223 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MMP, LMT |
License Number: | MT026903 |
Business Practice Address: | 4821 Fredericksburg Rd San Antonio, TX - 782293671 |
Business Phone Number: | 2103991864 |
Business Fax Number: | |
Mailing Address: | 902 Kitty Hawk Rd, Suite170 Box 469 UNIVERSAL CITY |
State: | TX |
Postal Code: | 781483825 |
Phone Number: | 2103991864 |
Fax Number: | |
NPI Enumeration Date: | 03/17/2008 |
NPI Last Update Date: | 11/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT026903 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |