Provider Demographics
NPI:1881968683
Name:REITZNER, LINDSEY R (DC)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:R
Last Name:REITZNER
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:PO BOX 930226
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-0226
Mailing Address - Country:US
Mailing Address - Phone:608-630-2645
Mailing Address - Fax:
Practice Address - Street 1:413 W VERONA AVE
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-1318
Practice Address - Country:US
Practice Address - Phone:608-630-2645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4829-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor