MEDICARE: DR. PAULA GRUENSFELDER REYNOLDS D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1926	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0876K	OTHER	NC	BCBS
3	100950	OTHER	NC	ACN

General Provider Information

NPI Number	:	1144282039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAULA GRUENSFELDER REYNOLDS D.C.

Provider Business Mailing Address
First Line	:	138 MAIN ST E
Second Line	:
City	:	VALDESE
State	:	NC
Zip	:	28690-2808
Country	:	US
Telephone Number	:	828-874-6292
Fax Number	:	828-874-6292

Provider Business Practice Location Address
First Line	:	138 MAIN ST E
Second Line	:
City	:	VALDESE
State	:	NC
Zip	:	28690-2808
Country	:	US
Telephone Number	:	828-874-6292
Fax Number	:	828-874-6292

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	06/22/2010

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