Provider Demographics
NPI:1477206191
Name:CHOQUETTE, RENEE
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:CHOQUETTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6755 BLAINE AVE
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55076-1901
Mailing Address - Country:US
Mailing Address - Phone:712-577-0872
Mailing Address - Fax:
Practice Address - Street 1:6755 BLAINE AVE
Practice Address - Street 2:
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55076-1901
Practice Address - Country:US
Practice Address - Phone:712-577-0872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6954111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor