Provider Demographics
NPI:1518494335
Name:REDING, BREONNA (DC)
Entity type:Individual
Prefix:
First Name:BREONNA
Middle Name:
Last Name:REDING
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 1:23048 POCKET RD
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006-9509
Mailing Address - Country:US
Mailing Address - Phone:785-527-3850
Mailing Address - Fax:812-932-3008
Practice Address - Street 1:10 BEDEL BLVD STE C
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-9118
Practice Address - Country:US
Practice Address - Phone:812-932-3003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7616111N00000X
IN08003050A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor