Provider Demographics
NPI:1609089747
Name:REINECKE CHIROPRACTIC CLINIC, INC.
Entity Type:Organization
Organization Name:REINECKE CHIROPRACTIC CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAX
Authorized Official - Middle Name:W
Authorized Official - Last Name:REINECKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-335-0880
Mailing Address - Street 1:2821 S CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-4817
Mailing Address - Country:US
Mailing Address - Phone:605-335-0880
Mailing Address - Fax:605-335-8506
Practice Address - Street 1:2821 S CENTER AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-4817
Practice Address - Country:US
Practice Address - Phone:605-335-0880
Practice Address - Fax:605-335-8506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty