Provider Demographics
NPI:1760816631
Name:REAL HEALTH CHIROPRACTIC
Entity Type:Organization
Organization Name:REAL HEALTH CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:RUEBBELKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:309-797-9777
Mailing Address - Street 1:1601 52ND AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-6389
Mailing Address - Country:US
Mailing Address - Phone:309-797-9777
Mailing Address - Fax:309-797-1007
Practice Address - Street 1:1601 52ND AVE STE 5
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-6389
Practice Address - Country:US
Practice Address - Phone:309-797-9777
Practice Address - Fax:309-797-1007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty