Provider Demographics
NPI:1700190659
Name:RIXIE, JUSTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:
Last Name:RIXIE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 CENTER AVE
Mailing Address - Street 2:#2
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-5622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8333 GREENWAY BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-3684
Practice Address - Country:US
Practice Address - Phone:608-836-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-03
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4627-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor