Provider Demographics
NPI:1356977334
Name:DEFNET, RACHEL (DC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:DEFNET
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 1:11129 N WAUWATOSA RD
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53097-3431
Mailing Address - Country:US
Mailing Address - Phone:414-354-5377
Mailing Address - Fax:414-354-0523
Practice Address - Street 1:N96W18743 COUNTY LINE RD STOP E
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-7100
Practice Address - Country:US
Practice Address - Phone:262-253-6779
Practice Address - Fax:262-257-9502
Is Sole Proprietor?:No
Enumeration Date:2020-03-21
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5506-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor