Provider Demographics
NPI:1528164589
Name:HIGASHI-REYNOLDS, KAREN LYNN (OD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNN
Last Name:HIGASHI-REYNOLDS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 VINDICATOR DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-3623
Mailing Address - Country:US
Mailing Address - Phone:719-590-1744
Mailing Address - Fax:
Practice Address - Street 1:1910 VINDICATOR DR
Practice Address - Street 2:SUITE 102
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-3623
Practice Address - Country:US
Practice Address - Phone:719-590-1744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO1914152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist