Provider Demographics
NPI:1295898096
Name:REICHENBACH, DAREN E (DC)
Entity type:Individual
Prefix:DR
First Name:DAREN
Middle Name:E
Last Name:REICHENBACH
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 1:6665 PEARL RD STE A
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3819
Mailing Address - Country:US
Mailing Address - Phone:440-845-3666
Mailing Address - Fax:440-845-3442
Practice Address - Street 1:6665 PEARL RD STE A
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3819
Practice Address - Country:US
Practice Address - Phone:440-845-3666
Practice Address - Fax:440-845-3442
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2019041Medicaid