Provider Demographics
NPI:1346719796
Name:REIBER, MADISON NICHOLE (DC)
Entity Type:Individual
Prefix:DR
First Name:MADISON
Middle Name:NICHOLE
Last Name:REIBER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3151 FISH HATCHERY RD.
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53713
Mailing Address - Country:US
Mailing Address - Phone:620-794-7234
Mailing Address - Fax:
Practice Address - Street 1:3151 FISH HATCHERY RD.
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53713
Practice Address - Country:US
Practice Address - Phone:620-794-7234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5387-12111N00000X
WI5387111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor