Provider Demographics
NPI:1184848111
Name:REINEN CHIROPRACTIC OFFICE
Entity Type:Organization
Organization Name:REINEN CHIROPRACTIC OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:REINEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:608-845-8860
Mailing Address - Street 1:115 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-9122
Mailing Address - Country:US
Mailing Address - Phone:608-845-8860
Mailing Address - Fax:
Practice Address - Street 1:115 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-9122
Practice Address - Country:US
Practice Address - Phone:608-845-8860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1716111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39002900Medicaid
WI39002900Medicaid
WIT6390Medicare UPIN