Provider Demographics
NPI:1508004011
Name:RECKELHOFF, KATHERINE (DC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:RECKELHOFF
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 1:16921 MANCHESTER RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63040-1209
Mailing Address - Country:US
Mailing Address - Phone:636-352-9718
Mailing Address - Fax:
Practice Address - Street 1:16921 MANCHESTER RD
Practice Address - Street 2:SUITE B
Practice Address - City:WILDWOOD
Practice Address - State:MO
Practice Address - Zip Code:63040-1209
Practice Address - Country:US
Practice Address - Phone:636-352-9718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009000024111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor