Provider Demographics
NPI:1124005772
Name:RASCHKE, MATTHEW PAUL (DC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:PAUL
Last Name:RASCHKE
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 1:425 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PIPESTONE
Mailing Address - State:MN
Mailing Address - Zip Code:56164-1936
Mailing Address - Country:US
Mailing Address - Phone:507-215-0739
Mailing Address - Fax:
Practice Address - Street 1:425 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PIPESTONE
Practice Address - State:MN
Practice Address - Zip Code:56164-1936
Practice Address - Country:US
Practice Address - Phone:507-215-0739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-26
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4299111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor