Healthcare Provider Details

I. General information

NPI: 1194263293
Provider Name (Legal Business Name): CHRISTOPHER JOHN REYNOLDS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2017
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16800 37TH PL N STE 200
PLYMOUTH MN
55446-2805
US

IV. Provider business mailing address

3500 AMERICAN BLVD W STE 300
BLOOMINGTON MN
55431-4442
US

V. Phone/Fax

Practice location:
  • Phone: 763-520-7870
  • Fax:
Mailing address:
  • Phone: 952-512-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number73566
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: