Provider Demographics
NPI:1235259003
Name:RINEHART, DOUGLAS M (DC)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:M
Last Name:RINEHART
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 1:2225 S KANNER HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-4619
Mailing Address - Country:US
Mailing Address - Phone:772-287-0122
Mailing Address - Fax:772-288-0160
Practice Address - Street 1:2225 S KANNER HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-4619
Practice Address - Country:US
Practice Address - Phone:772-287-0122
Practice Address - Fax:772-288-0160
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 4394111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88052Medicare ID - Type Unspecified