Provider Demographics
NPI:1821741109
Name:REINKE, ZOELLE (DC)
Entity Type:Individual
Prefix:
First Name:ZOELLE
Middle Name:
Last Name:REINKE
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 1:1670 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54935-1842
Mailing Address - Country:US
Mailing Address - Phone:920-517-1221
Mailing Address - Fax:
Practice Address - Street 1:21 N PORTLAND ST STE 1B
Practice Address - Street 2:
Practice Address - City:FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54935-3465
Practice Address - Country:US
Practice Address - Phone:920-306-4102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5721-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor