Provider Demographics
NPI:1245569573
Name:POPE, NICHOLAS REINHART (DC)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:REINHART
Last Name:POPE
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 1:729 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53403-1135
Mailing Address - Country:US
Mailing Address - Phone:262-880-7175
Mailing Address - Fax:
Practice Address - Street 1:414 6TH ST
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53403-1218
Practice Address - Country:US
Practice Address - Phone:262-637-1822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4554-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor