Provider Demographics
NPI:1114130804
Name:RICE, REBECCA JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:JEAN
Last Name:RICE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:JEAN
Other - Last Name:HAMPLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:14 LAKE BAY
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55127-6208
Mailing Address - Country:US
Mailing Address - Phone:651-482-0343
Mailing Address - Fax:763-757-4108
Practice Address - Street 1:11919 CENTRAL AVE NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55434-3911
Practice Address - Country:US
Practice Address - Phone:763-757-1660
Practice Address - Fax:763-757-4108
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor