Provider Demographics
NPI:1699860320
Name:ADAMEK PECKELS, REBECCA (DC)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:ADAMEK PECKELS
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 1:5000 W 36TH ST STE 120
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-2758
Mailing Address - Country:US
Mailing Address - Phone:612-922-8100
Mailing Address - Fax:
Practice Address - Street 1:5000 W 36TH ST STE 120
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55416-2758
Practice Address - Country:US
Practice Address - Phone:612-922-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4104111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4487340OtherMEDICA
MN53D96ADOtherBCBS
MN75250OtherHEALTHPARTNERS
MN1833842OtherARAZ
MN53D96ADOtherBCBS