Provider Demographics
NPI:1881801587
Name:REINHARDT, JEFFREY R (DC)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:R
Last Name:REINHARDT
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 1:569 32 RD
Mailing Address - Street 2:SUITE 5C
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81504-7053
Mailing Address - Country:US
Mailing Address - Phone:970-263-0633
Mailing Address - Fax:970-263-4047
Practice Address - Street 1:569 32 RD
Practice Address - Street 2:SUITE 5C
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81504-7053
Practice Address - Country:US
Practice Address - Phone:970-263-0633
Practice Address - Fax:970-263-4047
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2985111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC801324Medicare ID - Type Unspecified