Provider Demographics
NPI:1023020187
Name:RAINKA, ANTHONY S (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:S
Last Name:RAINKA
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 1:451 NW MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:MA
Mailing Address - Zip Code:01516-2212
Mailing Address - Country:US
Mailing Address - Phone:508-476-0112
Mailing Address - Fax:508-865-5069
Practice Address - Street 1:214 WORCESTER PROVIDENCE TPKE
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:MA
Practice Address - Zip Code:01590-2902
Practice Address - Country:US
Practice Address - Phone:508-865-5068
Practice Address - Fax:508-865-5069
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2285111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY45224Medicare PIN
MAY4522401Medicare PIN
MAU74167Medicare UPIN