Provider Demographics
NPI:1881819845
Name:R E B 3 INC
Entity Type:Organization
Organization Name:R E B 3 INC
Other - Org Name:BUSCH CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:BUSCH
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:260-471-4090
Mailing Address - Street 1:5005 RIVIERA CT
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-5805
Mailing Address - Country:US
Mailing Address - Phone:260-471-4090
Mailing Address - Fax:260-471-9919
Practice Address - Street 1:5005 RIVIERA CT
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-5805
Practice Address - Country:US
Practice Address - Phone:260-471-4090
Practice Address - Fax:260-471-9919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001648111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN669330AMedicare PIN
INU62328Medicare UPIN