Provider Demographics
NPI:1477147684
Name:RIECK, TAYLOR ANNE (DC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ANNE
Last Name:RIECK
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 1:529 2ND ST STE D
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-2507
Mailing Address - Country:US
Mailing Address - Phone:715-808-9333
Mailing Address - Fax:
Practice Address - Street 1:529 2ND ST STE D
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-2507
Practice Address - Country:US
Practice Address - Phone:715-808-9333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-28
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5622111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor