Provider Demographics
NPI:1598933186
Name:RIESGRAF CHIROPRACTOR CLINIC LTD
Entity Type:Organization
Organization Name:RIESGRAF CHIROPRACTOR CLINIC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:RIESGRAF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-448-3900
Mailing Address - Street 1:1476 WHITE OAK DR
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-2525
Mailing Address - Country:US
Mailing Address - Phone:952-448-3900
Mailing Address - Fax:
Practice Address - Street 1:1476 WHITE OAK DR
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-2525
Practice Address - Country:US
Practice Address - Phone:952-448-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty