Individual
CARMEN LORENIA REYNAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2424 S COTTONWOOD LN UNIT 151, TUCSON, AZ 85713-2717
(520) 313-1050
(520) 750-0056
Mailing address
870 W MIRACLE MILE, TUCSON, AZ 85705-3708
(520) 750-9667
(520) 750-0056
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
4205
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210142
—
AZ
Enumeration date
05/25/2007
Last updated
12/06/2012
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