Provider Demographics
NPI:1407919061
Name:RIEGLEMAN, MICHELLE ADELE (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ADELE
Last Name:RIEGLEMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MRS
Other - First Name:MICHELLE
Other - Middle Name:ADELE
Other - Last Name:RIEGLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:403 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-1814
Mailing Address - Country:US
Mailing Address - Phone:262-646-6400
Mailing Address - Fax:262-646-6443
Practice Address - Street 1:403 GENESEE ST
Practice Address - Street 2:
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-1814
Practice Address - Country:US
Practice Address - Phone:262-646-6400
Practice Address - Fax:262-646-6443
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3558111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI75377Medicare ID - Type Unspecified