Provider Demographics
NPI:1073694477
Name:THE CHIROPRACTORS, LLC
Entity Type:Organization
Organization Name:THE CHIROPRACTORS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:REBHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-691-0997
Mailing Address - Street 1:690 WESTFIELD WAY STE F
Mailing Address - Street 2:
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-2585
Mailing Address - Country:US
Mailing Address - Phone:262-691-0997
Mailing Address - Fax:262-875-3593
Practice Address - Street 1:690 WESTFIELD WAY STE F
Practice Address - Street 2:
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-2585
Practice Address - Country:US
Practice Address - Phone:262-691-0997
Practice Address - Fax:262-875-3593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4172-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38970200Medicaid
WI38970200Medicaid