Provider Demographics
NPI:1336675230
Name:RINEHART, SAMUEL OVID (DC)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:OVID
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 1:9405 36TH AVE N STE B
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55427-1776
Mailing Address - Country:US
Mailing Address - Phone:763-275-9099
Mailing Address - Fax:763-275-9095
Practice Address - Street 1:9405 36TH AVE N STE B
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55427-1776
Practice Address - Country:US
Practice Address - Phone:763-275-9099
Practice Address - Fax:763-275-9095
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6364111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor