Provider Demographics
NPI:1013233568
Name:RICKETTS, ABBY REE (DC)
Entity Type:Individual
Prefix:DR
First Name:ABBY
Middle Name:REE
Last Name:RICKETTS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ABBY
Other - Middle Name:REE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:104 W REDWOOD ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-1853
Mailing Address - Country:US
Mailing Address - Phone:507-532-2655
Mailing Address - Fax:507-532-2951
Practice Address - Street 1:104 W REDWOOD ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-1853
Practice Address - Country:US
Practice Address - Phone:507-532-2655
Practice Address - Fax:507-532-2951
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5393111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1013233568OtherNPI