Provider Demographics
NPI:1205997715
Name:RESCH, CHRISTOPHER DAVID (DC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DAVID
Last Name:RESCH
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 1:1511 S COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-4801
Mailing Address - Country:US
Mailing Address - Phone:920-720-0660
Mailing Address - Fax:920-720-0666
Practice Address - Street 1:1511 S COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-4801
Practice Address - Country:US
Practice Address - Phone:920-720-0660
Practice Address - Fax:920-720-0666
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2694-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI391-967021018OtherBLUE CROSS
WI38858700Medicaid
WI38858700Medicaid