Provider Demographics
NPI:1124118294
Name:REINHOLD, RICHARD WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WILLIAM
Last Name:REINHOLD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4640 SHORE DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-2859
Mailing Address - Country:US
Mailing Address - Phone:757-460-2522
Mailing Address - Fax:757-460-3810
Practice Address - Street 1:4640 SHORE DR
Practice Address - Street 2:SUITE 108
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-2859
Practice Address - Country:US
Practice Address - Phone:757-460-2522
Practice Address - Fax:757-460-3810
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001416111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU59465Medicare UPIN
VA350000622Medicare PIN