Provider Demographics
NPI:1073842969
Name:MADDOX-BURGER, REBECCA JANESS (DC)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:JANESS
Last Name:MADDOX-BURGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1042 SUTTON RD
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-8344
Mailing Address - Country:US
Mailing Address - Phone:517-759-4746
Mailing Address - Fax:517-759-4956
Practice Address - Street 1:1042 SUTTON RD
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-8344
Practice Address - Country:US
Practice Address - Phone:517-759-4746
Practice Address - Fax:517-759-4956
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-23
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009567111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor